The Search of the Stool and Blood K-ras Mutations in Patients With Pancreatic Mass

Tajima, Yoshitsugu; Kuroki, Tamotsu; Susumu, Seiya; Tsutsumi, Ryuji; Kitasato, Amane; Adachi, Tomohiko; Mishima, Takehiro; Kanematsu, Takashi

doi:10.1097/01.mpa.0000226891.71075.4c

Cited by 22 publications

(36 citation statements)

References 3 publications

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“…A single culprit microorganism was identified in each of the three previously reported cases. The microorganisms were Klebsiella ornithinolytica (Deeb (Fujimori et al, 2011), and Escherichia coli (Tajima et al, 2006). While Weinman reported a case of ASPD, the culprit microorganism was not identified (Weinman, 1995).…”

Section: Discussionmentioning

confidence: 98%

“…Similar to ascending cholangitis, the pancreatic duct fills with pus and the patient quickly decompensates. The treatment of choice is resuscitation, broad-spectrum antibiotics and emergent endoscopic decompression (Fujimori et al, 2011;Tajima et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…Acute obstructive suppurative cholangitis is a common clinical entity. However, pancreatic duct (PD) obstruction and acute suppuration of the pancreatic duct (ASPD) leading to sepsis, without a concurrent pancreatic abscess or infected pseudocyst, is an extremely rare complication with few cases reported in the English literature (Fujimori et al, 2011;Tajima et al, 2006). In ASPD, pancreatic obstruction results in the development of infection and pus within the PD, leading to sepsis.…”

Section: Introductionmentioning

confidence: 99%

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Acute Obstructive Suppuration of the Pancreatic Duct Causing Sepsis

Yakubov

Braha

Albert

et al. 2017

EJBM

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Objective: We report a rare case of acute obstructive suppuration of the pancreatic duct causing sepsis, which was successfully treated with emergent endoscopic retrograde cholangiopancreatography (ERCP). Methods: We describe the patient’s clinical presentation, laboratory test results, and imaging used for diagnosis and treatment. Results: A 33-year-old female with a history of recurrent acute pancreatitis was admitted during an episode of acute pancreatitis. Computed tomography (CT) scan of the abdomen revealed acute pancreatitis, diffuse pancreatic atrophy and pancreatic ductal dilatation with obstruction due to a soft tissue lesion within the distal duct. Shortly after admission she developed symptoms and signs of sepsis. Urgent ERCP was performed to further assess the suspected cholangitis. “Clean” bile emanated from the common bile duct, while copious purulent fluid was detected at the dilated pancreatic duct orifice, confirming suppuration of the pancreatic duct. A plastic single pigtail stent was placed traversing the ampulla and pancreatic duct stones that were causing the obstruction, which were later removed. After endoscopic decompression, the patient rapidly improved over the following 24 hours and had no subsequent admissions for pancreatitis.Conclusion: Acute suppuration of the pancreatic duct (ASPD) is a rare and potentially fatal infectious complication of pancreatic ductal obstruction with few cases reported in the English literature. It would be of interest to further investigate the exact pathophysiology leading to development of ASPD. The endoscopic methods of urgent ERCP and pancreatic duct decompression utilized in our case proved effective in successfully treating ASPD. This unusual condition should be considered in patients with acute pancreatitis who develop early clinical decompensation.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute Obstructive Suppuration of the Pancreatic Duct Causing Sepsis

Yakubov

Braha

Albert

et al. 2017

EJBM

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“…Tajima et al . [6] described AOSPD in the setting of pancreatic cancer; as it can predispose to infection from biliary or pancreatic obstruction.…”

Section: Discussionmentioning

confidence: 99%

Chronic pancreatitis with acute obstructive suppurative pancreatic ductitis: a rare case report

Gedam

Sadriwala

Bansod

2017

Journal of Surgical Case Reports

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Acute obstructive suppurative pancreatic ductitis (AOSPD) is a rare complication of chronic pancreatitis that has been described in only seven previous case reports since 1995. We report a case of a 33-year-old female a known case of chronic pancreatitis with computed tomography suggestive of dilated main pancreatic duct with multiple calcifications. On exploration, pancreatic duct aspiration revealed frank pus. Pus was drained after opening the pancreatic duct and longitudinal pancreaticojejunostomy was done. Patient was relieved of her symptoms after surgery. In conclusion, AOSPD should be considered in long standing cases of chronic pancreatitis. AOSPD appears to respond quickly after drainage procedure like longitudinal pancreaticojejunostomy and should be considered the treatment of choice.

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“…Weinman [1] reported the first case of ASPD characterized by purulent discharge. Acute suppurative cholangitis due to biliary ductal obstruction is a common disease, but there have been only a few reported cases of ASPD [2,3]. Drainage of the pancreatic duct is quite effective for relief of ASPD.…”

mentioning

confidence: 99%