A Rare Case of Pancreatitis From Pancreatic Herniation

Do, David; Mudroch, Steven; Chen, Patrick; Prakash, Rajan; Krishnamurthy, Padmini

doi:10.14740/jmc3036w

Cited by 7 publications

(6 citation statements)

References 10 publications

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“…En la mayoría de estos, es el cuerpo y la cola los que migran a través del diafragma, siendo la herniación de la cabeza pancreática un proceso extremadamente raro. Una revisión sistemática de los casos de páncreas herniados a través del hiato esofágico reportados desde 1958 hasta 2020, identifica tan solo 17 pacientes diagnosticados de pancreatitis aguda secundaria a hernias paraesofágicas tipo IV [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] (Tabla 1).…”

Section: Discussionunclassified

Pancreatitis aguda necrosante secundaria a hernia de hiato grado IV complicada: Presentación de un caso y revisión de la literatura

et al. 2021

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Introducción. En las hernias paraesofágicas tipo IV se produce la herniación del estómago junto a otros órganos abdominales. La herniación del páncreas es muy infrecuente. Caso clínico. Varón de 57 años que acude por dolor torácico, disnea e intolerancia al decúbito. En la tomografía computarizada toracoabdominal se observa hernia diafragmática que contiene colon transverso, intestino delgado y páncreas, con reticulación de la grasa alrededor del mismo, compatible con pancreatitis aguda. Conclusión. La asociación de hernia hiatal con páncreas herniado y pancreatitis es extremadamente infrecuente. El diagnóstico se estableció mediante tomografía computarizada y el tratamiento fue conservador, con cirugía diferida de la hernia de hiato.

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Section: Discussionunclassified

Pancreatitis aguda necrosante secundaria a hernia de hiato grado IV complicada: Presentación de un caso y revisión de la literatura

et al. 2021

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“…Herniation of pancreas can be without symptoms and found accidentally on imaging or as a sequel to acute pancreatitis. Acute pancreatitis as a sequela of this mechanism is very rare and has been previously reported in 13 patients [13][14][15][16][17][18][19][20][21][22][23][24][25]. Table 1 lists acute pancreatitis caused by the herniation of pancreas in HH from previous reports.…”

Section: Discussionmentioning

confidence: 99%

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

2020

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Background: Hiatal hernia is defined by the permanent or intermittent prolapse of any abdominal structure into the chest through the diaphragmatic esophageal hiatus. Prolapse of the stomach, intestine, transverse colon, and spleen is relatively common, but herniation of the pancreas is a rare condition. We describe a case of acute pancreatitis and bile duct dilatation secondary to a massive hiatal hernia of pancreatic body and tail. Case presentation: An 86-year-old woman with hiatal hernia who complained of epigastric pain and vomiting was admitted to our hospital. Blood tests revealed a hyperamylasemia and abnormal liver function test. Computed tomography revealed prolapse of the massive hiatal hernia, containing the stomach and pancreatic body and tail, with peripancreatic fluid in the posterior mediastinal space as a sequel to pancreatitis. In addition, intrahepatic and extrahepatic bile ducts were seen to be dilated and deformed. After conservative treatment for pancreatitis, an elective operation was performed. There was a strong adhesion between the hernial sac and the right diaphragmatic crus. After the stomach and pancreas were pulled into the abdominal cavity, the hiatal orifice was closed by silk thread sutures (primary repair), and the mesh was fixed in front of the hernial orifice. Toupet fundoplication and intraoperative endoscopy were performed. The patient had an uneventful postoperative course post-procedure. Conclusion: A rare massive hiatal hernia, involving the stomach and pancreatic body and tail, can cause acute pancreatitis with bile duct dilatation. The etiology can be flexure of the main pancreatic and extrahepatic bile ducts. Symptomatic herniation is best treated with surgery. Elective surgery is thought to be safer than emergent surgery in patients with serious complications.

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“…A review of literature reveals that the majority of cases of acute pancreatitis due to a herniated pancreas have been reported in elderly patients with significant comorbidities [3,4,10]. More interestingly, the most common finding in this population was herniation of both the body and tail of the pancreas together causing acute pancreatitis [3,4,10]. So far, there have been only two cases that reported herniation of only the tail of the pancreas, and both involved a congenital diaphragmatic hernia [8,9].…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis due to pancreatic tail herniation above the left hemidiaphragm

Brian¹,

Grech²,

Alaa³

et al. 2020

J Case Rep Images Med

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A 29-year-old female with past medical history of gastroesophageal reflux disease and obesity came to the emergency department with a chief complaint of left upper quadrant abdominal pain. Her symptoms started three days prior after eating a meal. She described the pain as 10/10 intermittent pain that radiated to the back associated with nausea, vomiting, and diaphoresis. She denied alcohol abuse, trauma, or prior abdominal surgeries or procedures. She did not take any medications. Her vital signs were within normal limits. On physical exam, the only notable finding was left upper quadrant tenderness upon palpation.Laboratory studies showed leukocytosis of 14.8 × 10 3 cells/mm 3 (normal: 3.6-10.2 × 10 3 cells/mm 3 ), hematocrit 41.9% (normal: 36.7-47.1%), blood urine nitrogen of 11 mg/dL (normal: 8-21 mg/dL), creatinine of 0.83 mg/ dL (normal: 0.57-1.11 mg/dL), and calcium level of 9.3 mg/dL (

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A Rare Case of Pancreatitis From Pancreatic Herniation

Cited by 7 publications

References 10 publications

Pancreatitis aguda necrosante secundaria a hernia de hiato grado IV complicada: Presentación de un caso y revisión de la literatura

Pancreatitis aguda necrosante secundaria a hernia de hiato grado IV complicada: Presentación de un caso y revisión de la literatura

Massive hiatal hernia involving prolapse of the entire stomach and pancreas resulting in pancreatitis and bile duct dilatation: a case report

Acute pancreatitis due to pancreatic tail herniation above the left hemidiaphragm

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