Spontaneous Rupture of Pancreatic Pseudocyst: Report of Two Cases

Case Reports in Surgery ◽

10.1155/2016/7056567 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Ricardo Rocha ◽

Rui Marinho ◽

António Gomes ◽

Marta Sousa ◽

Nuno Pignatelli ◽

...

Keyword(s):

Spontaneous Rupture ◽

Pancreatic Pseudocyst ◽

Technical Difficulty ◽

Pancreatic Pseudocysts ◽

Internal Drainage ◽

Common Complication ◽

Gi Tract ◽

External Drainage ◽

Severe Peritonitis

Introduction. Pancreatic pseudocysts are a common complication of acute pancreatitis. Pancreatic pseudocyst’s natural history ranges between its spontaneous regression and the settlement of serious complications if untreated, such as splenic complications, hemorrhage, infection, biliary complications, portal hypertension, and rupture. The rupture of a pancreatic pseudocyst to the peritoneal cavity is a dangerous complication leading to severe peritonitis and septic conditions. It requires emergent surgical exploration that is often of great technical difficulty and with important morbidity and mortality.Case Study. We present two cases of spontaneous rupture of pancreatic pseudocysts, managed differently according to the local and systemic conditions.Conclusion. The best surgical choice is the internal drainage of the cyst to the GI tract; however, in some conditions, the external drainage is the only choice available.

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Procena stepena maturacije zida pseudociste pankreasa u odnosu na izbor operativne procedure

Acta chirurgica iugoslavica ◽

10.2298/aci0501033d ◽

2005 ◽

Vol 52 (1) ◽

pp. 33-39

Author(s):

Z. Djordjevic ◽

S. Knezevic ◽

M. Ceranic ◽

P. Bulajic ◽

S. Ostojic ◽

...

Keyword(s):

Pancreatic Pseudocyst ◽

Mortality Rates ◽

University Hospital ◽

Pancreatic Pseudocysts ◽

Internal Drainage ◽

Common Complication ◽

High Concentration ◽

Pancreatic Tail ◽

Digestive Diseases ◽

Male Patients

The aim of this study is to present our experience in the diagnosis and treatment of pancreatic pseudocysts. A pancreatic pseudocyst is an incapsulated collection of pancreatic juice, enclosed by nonepithelial elements, containing a high concentration of pancreatic enzymes, bicarbonates and necrotic detritus. It is a common complication of acute pancreatitis and trauma of the pancreas. In the period between 1996 and 2001, 53 surgical procedures were performed for pancreatic pseudocyst at the Institute for Digestive Diseases (First Surgical University Hospital), 35 male patients (67%) and 17 female patients (33%) underwent surgery. In 39 (75%) patients the method of choice was cystojejunostomy by Roux. In 4 cases distal pancreatectomy for pseudocysts localized within the pancreatic tail was performed, complete pseudocyst excision only was performed in one case and complete pseudocyst excision combined with cystojejunostomy was also performed in one case. Cystogastrostomy and drainage in one case and partial cystectomy and drainage also in one case. Surgical internal drainage is the method of choice for the treatment of pancreatic pseudocysts, involving low morbidity and mortality rates.

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ERCP in Evaluating The Mode of Therapy in Pancreatic Pseudocyst

HPB Surgery ◽

10.1155/1988/47060 ◽

1988 ◽

Vol 1 (1) ◽

pp. 35-44 ◽

Cited By ~ 7

Author(s):

I. Nordback ◽

O. Auvinen ◽

I. Airo ◽

J. Isolauri ◽

O. Teerenhovi

Keyword(s):

Pancreatic Duct ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Main Pancreatic Duct ◽

Pancreatic Pseudocyst ◽

Treatment Method ◽

Internal Drainage ◽

Endoscopic Retrograde ◽

External Drainage ◽

Computed Tomographic ◽

Pancreatic Resections

Twenty patients with ultrasonographic or computed tomographic diagnosis of pancreatic pseudocyst were referred for endoscopic retrograde cholangiopancreatography (ERCP). Two of these were found at laparotomy not to have pseudocysts and were excluded. Pancreatography was successful in 15 out of 18 cases (83%) and cholangiography in 12 out of 18 cases (67%). Three types of pseudocysts were noticed according to the communication of the pseudocyst to the main pancreatic duct and the presence of pancreatic duct stensosis. Successful treatment included two spontaneous resolutions, two internal drainages and three left pancreatic resections. In the eight percutaneous external drainages four recurrences (50%) occurred, one after closure of temporary pancreatocutaneous fistula. All the recurrences occurred in Type III pseudocysts with communication of the pseudocysts to stenotic main pancreatic duct. In these cases internal drainage would have been the preferable treatment method. We believe that by ERCP one can identify pseudocysts not suitable for external drainage.

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The results of endosonography-assisted internal drainage of pancreatic pseudocyst

Annaly khirurgicheskoy gepatologii = Annals of HPB surgery ◽

10.16931/1995-5464.2019143-52 ◽

2019 ◽

Vol 24 (1) ◽

pp. 43-52

Author(s):

Yu. G. Starkov ◽

R. D. Zamolodchikov ◽

S. V. Dzhantukhanova ◽

M. I. Vyborniy ◽

K. V. Lukich ◽

...

Keyword(s):

Success Rate ◽

Pancreatic Pseudocyst ◽

Clinical Success ◽

Clinical Success Rate ◽

Long Term Results ◽

Surgical Approaches ◽

Pancreatic Pseudocysts ◽

Endoscopic Drainage ◽

Internal Drainage

Aim.To compare immediate and long-term results of internal drainage of pancreatic pseudocyst by using of endosonography-assisted and open surgical approaches.Material and methods.EUS-assisted internal drainage of pancreatic pseudocyst was performed in 32 patients in 2011–2016. Open drainage procedures were carried out on the other 32 patients.Results.In the group of endoscopic drainage, technical success rate, clinical success rate and complication rate were 97%, 85% and 26%, respectively. There were no recurrent pseudocysts in long-term period. Comparison with open surgery confirmed advantages of endoscopic technique regarding time of operation (p< 0.01), intraoperative blood loss (p< 0.01) and length of hospital-stay (p< 0.01).Conclusion.EUS-assisted internal drainage of pancreatic pseudocysts in the treatment of chronic pancreatitis is characterized by high rate of technical and clinical success, small postoperative morbidity and low incidence of longterm recurrences.

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An unusual cause of psoas abscess

Acute Medicine Journal ◽

10.52964/amja.0002 ◽

2002 ◽

Vol 1 (2) ◽

pp. 26-27

Author(s):

A K Choudhury ◽

◽

Praveen Bhatia ◽

Keyword(s):

Pancreatic Pseudocyst ◽

Psoas Abscess ◽

Pancreatic Pseudocysts ◽

Management Options

This case study reports an uncommon cause of psoas abscess, a complication of pancreatic pseudocyst in a 75 years old man. A few other causes of psoas abscess and some complications of pancreatic pseudocyst are touched upon in this report,and management options in the treatment of pancreatic pseudocysts have been enumerated.

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An unusual presentation of a giant pancreatic pseudocyst extending through the lateral abdominothoracic wall into the subcutaneous plane

International Surgery Journal ◽

10.18203/2349-2902.isj20204988 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4161

Author(s):

Daniel Page ◽

Suresh Munugani

Keyword(s):

Conservative Management ◽

Literature Search ◽

Pancreatic Pseudocyst ◽

Unusual Presentation ◽

Pancreatic Pseudocysts ◽

Chronic Alcohol ◽

Common Complication ◽

Pancreatic Tail ◽

Specific Complication ◽

Subcutaneous Plane

Pancreatic pseudocysts are a common complication of pancreatitis affecting up to 40% of chronic cases. Typically, they are located within or abutting the pancreas and are self-limiting with the majority been smaller than 6cm, asymptomatic and resolving with conservative management. Here we present an unusual multiloculated giant pancreatic pseudocyst that originated at the pancreatic tail and extended through the lateral thoracoabdominal walls into the subcutaneous plane in a male with chronic alcohol pancreatitis. A literature search revealed no previous documented cases of this specific complication.

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PSEUDOKISTA PANKREAS

Majalah Kedokteran Andalas ◽

10.22338/mka.v35.i1.p61-67.2011 ◽

2011 ◽

Vol 35 (1) ◽

pp. 61

Author(s):

Asril Zahari ◽

Fahmi Fahmi

Keyword(s):

Pancreatic Duct ◽

Male Patient ◽

Abdominal Trauma ◽

Pancreatic Pseudocyst ◽

Pancreatic Enzymes ◽

Pancreatic Pseudocysts ◽

Internal Drainage ◽

History Of ◽

Local Accumulation ◽

Cyst Cavity

AbstrakPseudokista Pankreas merupakan penumpukan cairan yang terlokalisir yang kaya amilase dan enzim pankreas lainnya, yang memiliki dinding yang tidak berepitel. Ukuran bervariasi 2-30 cm. Sekitar sepertiga dari pseudokista terjadi pada caput pankreas, dan dua pertiga muncul di bagian ekor. Patogenesis pseudokista pankreas berasal dari gangguan saluran pankreas akibat pankreatitis dan ekstravasasi bahan enzimatik. Pada anak-anak, pseudokista pankreas sering berhubungan dengan trauma.Dilaporkan seorang pasien laki- laki umur 21 tahun dengan benjolan di perut. Pasien dengan riwayat trauma diperut 2 bulan sebelum masuk rumah sakit, kemudian muncul benjolan diperut yang makin lama-makin membesar. Pasien juga mengeluh sering mual dan penurunan nafsu makan. Pada perabaan dijumpai benjolan kistik fluktuatif dan terfikisir dengan ukuran ±30x20 cm, dan nyeri. Pada pemeriksaan scaning dijumpai gambaran rongga kista disekitar pankreas. Pasien didiagnosa dengan pseudokista pankreas. Pada pasien dilakukan drainase interna kista-yeyunostomi, yeyuno-yeyunostomi side to side dan brown anastomose. Dari pemeriksaan patologi anatomi didapatkan kesan suatu pseudokista pankreas.Follow up sampai 2 bulan post operasi tidak dijumpai komplikasi.Drainase interna kista-yeyunostomi, yeyuno-yeyunostomi side to side dan brown anastomose pada pseudokista pancreas memberikan hasil yang baik.Kata kunci : Pseudokista, Trauma, pankreatitisAbstractPancreatic Pseudocysts well defined as a local accumulation of fluid that rich in amylase and other pancreatic enzymes, that has nonepithelialized wall. Size varies from 2-30 cm. About one third of pseudocysts manifest in the head of the gland, and two thirds appear in the tail. Pathogenesis of pancreatic pseudocysts seems to stem from disruption of the pancreatic duct due to pancreatitis and extravasation of enzymatic material. In children, pancreatic pseudocysts are often associated with trauma.A male patient, 21 year old with a lump in the abdomen. Patient with a history of abdominal trauma 2 months before entering the hospital, then a lump appeared at the abdomen and continues to expand. Patient also complain of frequent nausea and decreased appetite. A pain cystic fluctuative and immobile lump that ± 30x20 cm in size was found in palpability. From abdominal scaning images, a cyst cavity around the pancreatic was found. Patient was diagnosed with pancreaticLAPORAN KASUS62pseudocyst. Patient underwent internal drainage of the cyst-yeyunostomi, yeyuno-yeyunostomi side to side and brown anastomose. From pathology anatomy the conclusion is a pancreatic pseudocyst.Follow-up to 2 months postoperative, no complications was found.The internal drainage of the cyst-yeyunostomi, yeyuno-yeyunostomi side to side and brown anastomose on pancreatic pseudocyst give a good results.Key word : Pseudocyst, Trauma, Pancreatitis

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Choice of minimally invasive method of treatment of pancreatic pseudocysts: a single center, retrospective study

Kazan medical journal ◽

10.17816/kmj2018-1016 ◽

2018 ◽

Vol 99 (6) ◽

pp. 1016-1021

Author(s):

L A Neledova ◽

D V Mizgirev ◽

B L Duberman

Keyword(s):

Retrospective Study ◽

Minimally Invasive ◽

Percutaneous Drainage ◽

Pancreatic Pseudocysts ◽

Internal Drainage ◽

Single Center ◽

External Drainage ◽

Special Investigation ◽

Drainage Group ◽

Group 1

Aim of the study is to evaluate efficacy of different methods of minimally invasive treatment of pancreatic pseudocysts (PPC). Methods. A single center retrospective study of patients with pancreatic pseudocysts (n = 17): 90 males (76.9 %), 27 females (23.1 %) aged 25 to 72 years. The patients underwent external percutaneous drainage (group 1, n = 96) or internal drainage (group 2, n = 21). The diagnosis of pseudocysts included clinical, laboratory (biochemical and bacteriological) and special investigation methods: radiological, endoscopic, ultrasound examination of hepatobiliary zone, computer tomography. Results. Complications in the early postoperative period were observed in patients from both groups 1 and 2. They were related to inefficacy of cystodigestive anastomosis, which required percutaneous drainage in 2 cases (9.5 %), or to formation of pancreatic fistula. Lethal outcomes were not observed. Readmission to surgical department for removal of the drainage was required in 28 (23.9 %) patients from group 1. Internal drainage is considered more advantageous for PPC decompression compared to external one due to persistence of pancreatic fluid passage through gastrointestinal tract. External drainage is associated with frequent external pancreatic fistulae formation as well as prolonged hospital stay and treatment in an outpatient setting worsening the quality of life, but it is an intervention of choice in somatically severely ill patients, in fast growing cyst, imperfectly formed wall and threatening cyst rupture into abdominal cavity or abscess. These aspects prevent from refusal from external drainage for PPC treatment. Conclusion. When choosing the optimal time and type of surgical intervention in PPC, the surgeon should evaluate localization, sizes, maturation of PC wall and its relation to pancreatic duct, somatic state and patient’s individual features.

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A rare case of giant pseudocyst of pancreas extending up to anterior abdominal wall requiring Roux en Y cystojejunostomy

International Surgery Journal ◽

10.18203/2349-2902.isj20212731 ◽

2021 ◽

Vol 8 (7) ◽

pp. 2180

Author(s):

Suresh G. ◽

Ramchandar Ramanan ◽

Sureshkumar Ayyappan

Keyword(s):

Abdominal Wall ◽

Rare Case ◽

Pancreatic Pseudocyst ◽

Anterior Abdominal Wall ◽

Chronic Alcoholism ◽

Endocrine Function ◽

Internal Drainage ◽

Common Complication ◽

Life Threatening ◽

Giant Pseudocyst

Pancreatic pseudocyst is rather a common complication following pancreatitis and chronic alcoholism related. Only few cases of giant pseudocyst measuring more than 10 cm of size or more in widest diameter has been reported in the literature. Possible attributable factors for less reported cases may be due to discripancies in sizing classification, in several studies the term 'large' or 'huge' were used instead of 'giant' when cyst measuring 10 cm or larger in its widest diameter. Pancreatic pseudocyst is usually sterile but when get secondarily infected may lead to life threatening complications such as pancreatc abscess which becomes very difficult to treat. Hence proper and timely intervention of giant pancreatic pseudocyst would probably reduce the risk of developing such dangerous complications. In the treatment of pancreatic pseudocyst to prevent recurrence and especially in protection of endocrine function of pancreas internal drainage is found to be more beneficial when compared to other modalities. This case demonstrates the successful use of Roux en Y cystojejunostomy to surgically drain a giant pancreatic pseudocyst at an unusual location.

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