scholarly journals Effectiveness of Endoscopic Pancreatic Stenting for Pancreatic Pseudocyst-Portal Vein Fistula

2020 ◽  
Vol 14 (3) ◽  
pp. 570-576
Author(s):  
Atsushi Kimura ◽  
Kazunao Hayashi ◽  
Chiyumi Oda ◽  
Kazunori Hosaka ◽  
Naruhiro Kimura ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Portal Vein ◽  
Pancreatic Pseudocyst ◽  
Effective Treatment Option ◽  
Surgical Interventions ◽  
Endoscopic Nasopancreatic Drainage ◽  
Threatening Condition ◽  
Life Threatening ◽  
Nasopancreatic Drainage ◽  
Pseudocyst Formation

Pancreatic pseudocyst-portal vein (PP-PV) fistula, mostly occurring after pseudocyst formation following acute/chronic pancreatitis, is a rare but life-threatening condition. The majority of treatments are based on conservative or surgical interventions. We report the case of a 70-year-old man with a PP-PV fistula and PV thrombosis. We adopted conservative treatment at first due to his mild symptoms. However, after resuming food intake, the patient had severe abdominal pain. Following endoscopic retrograde cholangiopancreatography, we found that the pseudocyst was connected with the PV through the fistula. Subsequently, an endoscopic nasopancreatic drainage (ENPD) catheter was inserted into the main pancreatic duct to establish pancreatic drainage, which resulted in a decrease in the abdominal pain. After the ENPD tube had been exchanged for endoscopic pancreatic stenting, his abdominal pain did not recur. Therefore, this case demonstrated endoscopic treatment as an effective treatment option for PP-PV fistula.

scholarly journals Spontaneous pancreatic pseudocyst–portal vein fistula: a rare and potentially life threatening complication of pancreatitis

2013 ◽  
Vol 95 (1) ◽  
pp. e7-e9 ◽  
Author(s):  
SS Raza ◽  
A Hakeem ◽  
M Sheridan ◽  
N Ahmad
Keyword(s):  
Chronic Pancreatitis ◽  
Portal Vein ◽  
Pancreatic Pseudocyst ◽  
Conservative Approach ◽  
Fatal Complication ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Acute And Chronic Pancreatitis ◽  
Pseudocyst Formation

Pseudocyst formation following acute and chronic pancreatitis is a well known complication. A pancreatic pseudocyst fistulating into the portal vein is a rare and potentially fatal complication. We report a case of pancreatic pseudocyst – portal vein fistula, which was managed with a conservative approach.

scholarly journals Atraumatic Splenic Rupture in a SARS-CoV-2 Patient: Case Report and Review of Literature

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marcello Agus ◽  
Maria Elena Ferrara ◽  
Paola Bianco ◽  
Cristina Manieli ◽  
Paolo Mura ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Rupture ◽  
Delayed Diagnosis ◽  
Caucasian Woman ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture ◽  
Rupture Of The Spleen ◽  
Delay Of Diagnosis ◽  
Possible Cause

Splenic rupture in the absence of trauma or previously diagnosed disease is rare. Due to the delay of diagnosis and treatment, this is a potentially life-threatening condition. We report a case of atraumatic splenic rupture in a SARS-CoV-2 patient. This report is of particular interest as it first identifies SARS-CoV-2 infection as a possible cause of spontaneous rupture of the spleen. A 46-year-old Caucasian woman presented at the emergency department pale and sweaty, complaining of syncopal episodes, tachycardia, hypotension, diarrhea, intense abdominal pain, diffuse arthromyalgia, and fever from the day before. RT-PCR was positive for SARS-CoV-2 infection. CT scan demonstrated extensive hemoperitoneum due to rupture of the splenic capsule. The patient required an emergency open splenectomy because of an unresponsive hemorrhagic shock. At the end of the surgery, the patient was relocated to a COVID-19 dedicated facility. COVID-19 is a new disease of which all manifestations are not yet known. Inpatients affected by SARS-CoV-2 infection with abdominal pain and spontaneous splenic rupture should be considered to avoid a delayed diagnosis.

scholarly journals Endoscopic follow-up of cyanoacrylate obliteration of gastric varices

2009 ◽  
Vol 46 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Fernanda Prata Martins ◽  
Erika Pereira de Macedo ◽  
Gustavo Andrade de Paulo ◽  
Frank Shigueo Nakao ◽  
José Celso Ardengh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Portal Hypertension ◽  
Gastric Varices ◽  
Study Endpoint ◽  
Mild Abdominal Pain ◽  
Threatening Condition ◽  
Life Threatening ◽  
Related Mortality ◽  
Overall Mortality

Bleeding from gastric varices is a life-threatening condition. We report our experience with cyanoacrylate injection. Twenty three patients with portal hypertension and gastric varices underwent intra-variceal injection of a cyanoacrylate/lipiodol solution (1:1). Study endpoint was variceal obliteration. Mean follow-up was 25.3 months. Variceal obliteration was achieved in 87% of patients. Recurrence occurred in one patient (4.3%) and rebleeding in another case (4.3%). Mild abdominal pain was described in 13% of patients. Overall mortality was 21.7% and rebleeding related mortality rate was 4.3%. Our results confirm that cyanoacrylate injection is effective and safe to eradicate gastric varices.

scholarly journals Acute Gastric Volvulus and Atrial Fibrillation with RVR: A Coincidence or Association

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Omar Nadhem ◽  
Omar Salh ◽  
Faisal Khasawneh
Keyword(s):  
Atrial Fibrillation ◽  
Abdominal Pain ◽  
Diaphragmatic Hernia ◽  
Gastric Volvulus ◽  
Shortness Of Breath ◽  
Threatening Condition ◽  
Acute Gastric Volvulus ◽  
Ventricular Response ◽  
Life Threatening ◽  
Upper Abdominal

Gastric volvulus is a rare and life-threatening condition that involves the abnormal rotation of the stomach around its axis by more than 180°. The association between acute gastric volvulus and atrial fibrillation with rapid ventricular response is rare with only few cases that have been reported. Our patient was an 86-year-old female who presented with upper abdominal pain, distension, nausea, and shortness of breath. Clinical and laboratory workup revealed acute gastric volvulus with diaphragmatic hernia. On presentation, she was also in atrial fibrillation with rapid ventricular response. She was successfully treated by laparotomy with reduction of the gastric volvulus and repair of the diaphragmatic hernia, with significant improvement.

scholarly journals Pancreatic pseudocyst-portal vein fistula with refractory hepatic pseudocyst: Two cases treated with EUS cyst-gastrostomy and review of the literature

2019 ◽  
Vol 07 (01) ◽  
pp. E83-E86 ◽  
Author(s):  
John Eccles ◽  
Edward Wiebe ◽  
Pernilla D’Souza ◽  
Gurpal Sandha
Keyword(s):  
Portal Vein ◽  
Pancreatic Pseudocyst ◽  
Pancreatic Cyst ◽  
Treatment Approach ◽  
Fistula Formation ◽  
Pancreatic Pseudocysts ◽  
Stent Insertion ◽  
Metal Stent ◽  
Pancreatic Fluid ◽  
Pseudocyst Formation

Abstract Background and study aims Pseudocysts are the most common pancreatic cystic lesions and they usually develop in association with pancreatitis of at least 4 weeks’ duration. Extra-pancreatic pseudocysts, although reported, are relatively uncommon. Secondary liver pseudocysts are recognized within the literature, and most patients described have required percutaneous or surgical drainage due to infection or symptoms. The mechanism of hepatic pseudocyst formation is not entirely clear but it is postulated that this phenomenon may occur through pseudocyst-portal vein fistulization. We describe two cases of patients presenting with pancreatic pseudocysts invading the portal venous system with embolization of pancreatic fluid to the liver and subsequent hepatic pseudocyst formation. Interestingly, liver pseudocyst resolution was incomplete with antibiotics and percutaneous drainage alone, and only occurred following endoscopic ultrasonography-guided pancreatic cyst-gastrostomy and metal stent insertion. We have reviewed the current literature on the diagnosis and management of pseudocyst-portal vein fistula formation and we believe that our cases represent the first published within the literature to describe this treatment approach.

scholarly journals Nonspecific abdominal pain: Do I have to allocate a specific diagnosis for every patient?

2022 ◽  
Keyword(s):  
Abdominal Pain ◽  
Care Setting ◽  
Acute Abdominal Pain ◽  
Scoring Systems ◽  
Acute Care Setting ◽  
Acute Setting ◽  
The World ◽  
Threatening Condition ◽  
Chief Complaints ◽  
Life Threatening

Acute abdominal pain is one of the most common chief complaints in the acute setting all over the world. The definitive diagnoses of these patients vary depending on age, gender, geographical and sociodemographic characteristics etc. Apart from these, aging of the population, obesity, advanced diagnostic imaging modalities and changes in nutritional habits also have an impact on the rates of specific diagnoses. On the other hand, nonspecific abdominal pain constitutes almost half of all visits due to acute abdominal pain in the acute care setting. This phenomenon is the main differential diagnostic problem in the management of these patients because missing a life-threatening condition can cause enormous medicolegal problems for the caregivers. Certain diagnostic scoring systems have also been developed to facilitate recognition and management of these conditions. This article aims to review the entity and underline the challenges it can bring to the scene.

scholarly journals Acute Cytomegalovirus infection as a cause of venous thromboembolism

2014 ◽  
Vol 6 (1) ◽  
pp. e2014041 ◽  
Author(s):  
Raffaella Lissandrin ◽  
Francesco Mojoli ◽  
Fausto Baldanti ◽  
Enrico Brunetti ◽  
Michela Pascarella ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Venous Thromboembolism ◽  
Vascular Endothelium ◽  
Cytomegalovirus Infection ◽  
Hcmv Infection ◽  
Thrombus Formation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Endothelium Damage ◽  
Acute Cytomegalovirus

Acute Human Cytomegalovirus (HCMV) Infection  is an unusual cause of venous thromboembolism, a potentially life-threatening condition. Thrombus formation can occur at the onset of the disease or later during recovery and may also occur in the absence of acute HCMV hepatitis. It is likely due to both vascular endothelium damage caused by HCMV and impairment of the clotting balance caused by the virus itself. Here we report on two immunocompetent women with splanchnic thrombosis that occurred during the course of acute HCMV infection. Although the prevalence of venous thrombosis in patients with acute HCMV infection is unknown, physicians should be aware of its occurrence, particularly in immune-competent patients presenting with fever and unexplained abdominal pain referred to the splanchnic region.

On-Scene and Final Assessments and Their Interrelationship Among Patients Who Use the EMS on Multiple Occasions

2017 ◽  
Vol 32 (5) ◽  
pp. 528-535 ◽  
Author(s):  
Julia Tärnqvist ◽  
Erik Dahlén ◽  
Gabriella Norberg ◽  
Carl Magnusson ◽  
Johan Herlitz ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Abdominal Pain ◽  
Chest Pain ◽  
Pulmonary Disease ◽  
Final Diagnosis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Threatening Condition ◽  
Life Threatening ◽  
Age Range

AbstractIntroductionThe use of Emergency Medical Services (EMS) is increasing. A number of patients call repeatedly for EMS. Early studies of frequent callers show that they form a heterogenous group.ProblemThere is a lack of research on frequent EMS callers. There is furthermore a lack of knowledge about characteristics and the prehospital assessment of the patients who call for EMS on several occasions. Finally, there is a general lack of knowledge with regard to the association between the prehospital assessment by health care providers and the final diagnosis.MethodPatients in Skaraborg in Western Sweden, who used the EMS at least four times in 2014, were included, excluding transport between hospitals. Information on the prehospital assessment on-scene and the final diagnosis was collected from the EMS and hospital case records.ResultsIn all, 339 individual patients who used the EMS on 1,855 occasions were included, accounting for five percent of all missions. Fifty percent were women. The age range was 10-98 years, but more than 50.0% were in the age range of 70-89 years.The most common emergency signs and symptoms (ESS) codes on the scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease (eight percent).Thirteen percent of all cases had a final diagnosis defined as a potentially life-threatening condition. Among these, 22.0% of prehospital assessments were retrospectively judged as potentially inappropriate.Forty-nine percent had a defined final diagnosis not fulfilling the criteria for a potentially life-threatening condition. Among these cases, 30.0% of prehospital assessments were retrospectively judged as potentially inappropriate.Conclusion:Among patients who used EMS on multiple occasions, the most common symptoms on-scene were dyspnea, chest pain, and abdominal pain. The most common final diagnosis was chronic obstructive pulmonary disease. In 13.0%, the final diagnosis of a potentially life-threatening condition was indicated. In a minority of these cases, the assessment on-scene was judged as potentially inappropriate.TärnqvistJ, DahlénE, NorbergG, MagnussonC, HerlitzJ, StrömsöeA, AxelssonC, Andersson HagiwaraM. On-scene and final assessments and their interrelationship among patients who use the EMS on multiple occasions. Prehosp Disaster Med. 2017;32(5):528–535.

scholarly journals A life-threatening condition – ruptured ectopic pregnancy with negative urine pregnancy test: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 121-123
Author(s):  
Fadzilah Mohamad ◽  
Ahmad Shuib Yahya ◽  
Aneesa Abdul Rashid ◽  
Navin Kumar Devaraj ◽  
Abdul Hadi Abdul Manap
Keyword(s):  
Abdominal Pain ◽  
Emergency Management ◽  
Ectopic Pregnancy ◽  
Case Reports ◽  
Rare Occurrence ◽  
Pregnancy Test ◽  
Threatening Condition ◽  
Life Threatening ◽  
Rule Out ◽  
Urine Pregnancy Test

Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

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