1/11. Complete recovery after spontaneous drainage of pancreatic abscess into the stomach.Pancreatic abscess is a dreaded complication of acute pancreatitis, with a high death rate even with aggressive surgical treatment. We report two cases in which recovery followed spontaneous drainage into the stomach. A 75-year-old woman with biliary pancreatitis and a 63-year-old man with ethanol-induced pancreatitis both developed pancreatic abscess, diagnosed by computed tomography scans and ultrasound. The spontaneous gastric fistula was heralded by a large emesis of purulent and necrotic material in one case and copious nasogastric tube secretions of a similar material in the other. Defervescence was immediate, and both patients went on to complete recovery without any further interventions. Contrast studies showed the fistulae. It is concluded that in the event that a pancreatic pseudocyst spontaneously drains into the stomach a 'wait and see' policy should be adopted, and a favorable outcome can be expected.- - - - - - - - - - ranking = 1keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
2/11. A retroperitoneal cystic leiomyosarcoma spontaneously draining into the stomach.An unusual case of a retroperitoneal cystic leiomyosarcoma clinically resembling a pancreatic pseudocyst with subsequent spontaneous cystgastrostomy drainage is presented.- - - - - - - - - - ranking = 1keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
3/11. Migration of steel-wire coils into the stomach after transcatheter arterial embolization for a bleeding splenic artery pseudoaneurysm: report of a case.Transcatheter arterial embolization (TAE) represents the primary, and often definitive, mode of therapy for bleeding splanchnic artery pseudoaneurysms (PSA). Nevertheless, a number of complications associated with this procedure have been described. We report herein the case of a 59-year-old man with chronic pancreatitis who was referred to us with hematemesis and hemorrhagic shock. Computed tomography revealed a splenic artery PSA bleeding into a pancreatic pseudocyst, and TAE was performed using steel-wire coils, placed inside the aneurysmal cavity, which resulted in the immediate cessation of bleeding. However, several weeks later some of the coils were found to have dislodged through a gastropseudocystic fistula. Furthermore, an early gastric cancer was incidentally found proximal to the fistula. We finally performed open surgery to treat both disorders; primarily for the gastric cancer, but also for the pseudocyst and fistula, with the intermittent discharge of the steel-wire coils. To our knowledge, migration into the stomach of steel-wire coils after TAE has not been described before. It is generally believed that the embolization procedure should occlude normal portions of the artery both distal and proximal to the PSA with embolization materials. By occluding the PSA in this way, the subsequent migration of steel-wire coils into the pseudocyst and stomach might have been prevented in our patient.- - - - - - - - - - ranking = 1.1492971109935keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
4/11. Spontaneous gastric decompression of pancreatic pseudocyst.Spontaneous resolution of pancreatic pseudocysts is being reported with increasing frequency. Although many mechanisms have been proposed one that is not frequently recognized is spontaneous decompression into the gastrointestinal tract. This case report demonstrates the mechanism of spontaneous resolution of a traumatic pancreatic pseudocyst, several weeks after injury, through fistulization between the pseudocyst and the stomach. Spontaneous resolution of a pancreatic pseudocyst after a transient episode of diarrhea should suggest the mechanism of gastrointestinal decompression of the pseudocyst.- - - - - - - - - - ranking = 7.099531407329keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
5/11. Spontaneous internal drainage of pancreatic pseudocysts.Six cases are reported in which spontaneous internal drainage between a pancreatic pseudocyst and the alimentary tract became established. In each instance the communication was demonstrated radiologically. The clinical circumstances and radiographic features of these cases are described, and the existing literature pertaining to this phenomenon is reviewed.- - - - - - - - - - ranking = 5keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
6/11. Ruptured pancreatic pseudocysts: diagnosis by endoscopy. Report of 3 cases.Report on 3 cases of spontaneous perforation of a pancreatic pseudocyst into the stomach; presenting symptom was in each case an acute upper GI-bleeding. The pseudocyst was endoscopically seen as a well delineated, hemorrhagic protrusion into the stomach. After full perforation the spontaneous ostium had the appearance of a surgical anastomosis. High amylase concentration in the aspirate ave further diagnostic evidence. All 3 patients survived, 2 of them without surgery.- - - - - - - - - - ranking = 5.0497657036645keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
7/11. CT demonstration of gastropancreatic fistula due to penetrating gastric ulcer.We report a patient with gas in the pancreatic duct due to a gastropancreatic fistula resulting from gastric ulcer. No mass or pseudocyst was demonstrated. This entity should be considered when patients with gas in the pancreas are encountered.- - - - - - - - - - ranking = 0.049765703664515keywords = pseudocyst (Clic here for more details about this article) |
8/11. pancreatic pseudocyst with gastric and colonic connections treated conservatively.A case of pancreatic pseuocyst with gastric and colonic connections developing after acute pancreatitis is reported. The successful treatment by conservative means is described and alternative methods of management are reviewed.- - - - - - - - - - ranking = 0.19906281465806keywords = pseudocyst (Clic here for more details about this article) |
9/11. Pancreatic pseudocysts communicating with the stomach: demonstration by endoscopic retrograde pancreatography.The use of endoscopic retrograde pancreatography (ERP) provides important information in the management of pancreatic pseudocysts unavailable by other methods. When the pseudocysts communicate with a hollow viscus, the surgeon is better able to deal with the problem if aware of this fact prior to operative intervention. A pancreatic pseudocyst communicating with the stomach was demonstrated by ERP in each of four patients. One of these patients had pancreatic ascites and the other had left-sided pleural effusion, and both were treated successfully by distal pancreatectomy. The other two patients responded to nonoperative treatment. This report emphasizes the potential diagonstic value of ERP in determining the presence and the fate of pseudocysts.- - - - - - - - - - ranking = 2.2985942219871keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
10/11. Transenteric rupture of pancreatic pseudocysts: management of pseudocystenteric fistulas.Among the protean presentations of pancreatic pseudocyst, spontaneous transenteric perforation is being reported with increasing frequency. review of the literature revealed 37 cases in which the diagnosis of transenteric perforation of a pseudocyst could be substantiated, 21 reported since 1960. Five additional cases are described, including the first case of pseudocystesophageal fistulization. Of the 26 recent cases, chronic alcoholism was associated with fistulization in 73 per cent (19/26), males outnumbered females 2:1, and the age at diagnosis ranged from 23-74. No predilection for any particular segment of intestine was apparent. All the patients had symptomatology suggestive of pancreatic disease. In addition, 54 per cent (14/26) had intestinal hemorrhage. In that group of patients with a palpable abdominal mass, the sudden disappearance of the mass as transenteric decompression occurred was pathognomonic. Defivitive diagnosis was best established by a combination of ultrasound and barium intestinal studies. The overall mortality rate was 27 per cent (7/26), all of the deaths occurring in those patients with hemorrhage complicating the pseudocystenteric fistula. Since spontaneous closure of the fistula may be expected, surgery should be reserved for those patients with incomplete spontaneous drainage or uncontrollable hemorrhage.- - - - - - - - - - ranking = 5.3483599256516keywords = pancreatic pseudocyst, pseudocyst (Clic here for more details about this article) |
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