Endoscopic ultrasonography-guided drainage for spontaneous rupture of a pancreatic pseudocyst into the peritoneal cavity in a patient with autoimmune pancreatitis

Koizumi, Kazuya; Masuda, Sakue; Tazawa, Tomohiko; Kako, Makoto; Teshima, Shin‐ichi

doi:10.1007/s12328-020-01104-9

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Autoimmune pancreatitis with ACF, most of them might be retention cyst, is a concern in relation to treatment effectiveness, because while most patients could be responsive to steroid treatment, others are refractory to steroid treatment and develop complications, such as hemorrhage, that require intervention. [13][14][15]18,22 However, there are rare case reports of AIP with necrosis (WON). 29 Although cases of ACF with large cysts have been reported to show poor response to steroid treatment, 11 we demonstrated in this study that steroid treatment has an important role as first-line monotherapy in cases of ACF, F I G U R E 3 ROC curves and cut-offs for the duration and the diameter of ACF concerning the remission.…”

Section: Discussionmentioning

confidence: 99%

“…only observation, without steroid treatment or drainage 25 . In patients in whom the ACF was associated with an aneurysm, embolization or resection was carried out 13,14,18,22 . Maintenance steroid therapy was employed to reduce the risk of relapse 26 .…”

Section: Methodsmentioning

confidence: 99%

“…25 In patients in whom the ACF was associated with an aneurysm, embolization or resection was carried out. 13,14,18,22 Maintenance steroid therapy was employed to reduce the risk of relapse. 26 Steroids were also re-administered to relapse patients.…”

Section: Therapeutic Strategymentioning

confidence: 99%

“…[10][11][12][13][14] Some patients with ACF are treated with steroids, [10][11][12][13][14][15] while others receive drainage with/without steroids or resection. [16][17][18][19][20][21][22] Cases of ACF with neoplastic transformation have been reported. 12 As the cysts in cases of ACR could be complicated by rupture, bleeding, and infection, early recognition of ACF would enable prompt and appropriate management.…”

Section: Introductionmentioning

confidence: 99%

“…Studies indicate that the cysts in cases of ACF are mainly located in the body or tail of the pancreas 10–14 . Some patients with ACF are treated with steroids, 10–15 while others receive drainage with/without steroids or resection 16–22 . Cases of ACF with neoplastic transformation have been reported 12 .…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Steroid therapy has an acceptable role as the initial treatment in autoimmune pancreatitis patients with pancreatic cyst formation: Based on a Japanese nationwide study

Kubota

Oguchi

Fujimori

et al. 2022

J Hepato Biliary Pancreat

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Background We attempted to determine the indications and limitations of steroid therapy as the first‐line therapy in patients with autoimmune pancreatitis (AIP) with cyst formation (ACF). Methods This Japanese multicenter survey was conducted to examine the merits/demerits of steroid treatment as the initial therapy for ACF. Results Data of a total of 115 patients with ACF were analyzed. Complete remission was achieved in 86% (86/100) of patients who had received steroid treatment, but only 33.3% (5/15) of patients who had not received steroids. Relapse after the remission (n = 86) occurred in 7.6% (6/86) of patients who had received steroid therapy, but 40% (2/5) of patients who had not received steroid therapy. Multivariate analysis identified adoption of the wait and watch approach without steroid treatment (odds ratio = 0.126, P < .001) as a significant and independent negative predictor of remission of ACF. As for predictors of relapse, the presence of varix (odds ratio = 5.83, P = .036) was identified as an independent risk factor. Conclusion Steroid therapy plays an important role as first‐line therapy in AIP patients with pancreatic cyst formation, however, varix formation, besides the diameter of the cyst(s), is a risk factor for refractoriness to steroid therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Therapeutic Strategymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Steroid therapy has an acceptable role as the initial treatment in autoimmune pancreatitis patients with pancreatic cyst formation: Based on a Japanese nationwide study

Kubota

Oguchi

Fujimori

et al. 2022

J Hepato Biliary Pancreat

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Spleen and Peritoneal Cavity

Duffy

Castro-Aragon

Tivnan

et al. 2021

Pediatric Ultrasound

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Imaging Features and Risk Factors of Pancreatic Cystic Lesions Complicating Autoimmune Pancreatitis: A Retrospective Study

Zhang

Hou

Chen

et al. 2023

CMIR

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Objective: This study aimed to explore the imaging features and risk factors of PCLs complicating AIP, and investigate its prognosis through continuous imaging follow-up. Patients and Methods: Patients who were diagnosed with AIP from January 2014 to December 2020 in our hospital were recruited. We analyzed the CT and MRI features of PCLs complicating AIP, and investigated its prognosis through imaging follow-up. We also compared subjects with and without PCLs using clinical, laboratory, and imaging data; the related risk factors associated with PCLs were investigated in a multivariate logistic regression analysis objective: This study aimed to explore the imaging features and risk factors of PCLs complicating AIP, and investigate its prognosis through continuous imaging follow-up. Results: In this group, 16 patients had PCLs and 86 did not. A total of 43 PCLs larger than 5mm were found in 15 patients. Among these PCLs, 35 showed homogeneous signal (density); one, bleeding; three, linear separation; and four, small focal low signal on T2WI. Eight patients with 23 PCLs appeared for the follow-up after steroid treatment. Short-term follow-up showed that 11 PCLs disappeared, nine reduced, one unchanged and two enlarged. Of the 12 PCLs that did not disappear, 10 PCLs disappeared at long-term follow-up, except for two reduced PCLs were not re-examined. Logistic regression analysis showed that drinking history was an independent risk factor, age ≥ 65 years was an independent protective factor for PCLs complicating AIP. Conclusion: The imaging features of PCLs complicating AIP are various, which can be single or multiple, most of them are homogeneous, and some lesions may be accompanied by hemorrhage, separation and necrosis. Age ≥ 65 years and avoiding drinking may help to reduce the occurrence of these lesions. result: In this group, 15 patients had PCLs and 86 patients did not. A total of 33 PCLs larger than 5mm were found in 14 patients. Among these PCLs, 25 showed homogeneous signal (density); one, bleeding; three, linear separation; and four, small focal low signal on T2WI. Eight patients with 23 PCLs were followed-up after steroid treatment. Short-term follow-up showed that 11 PCLs disappeared, nine reduced, one unchanged and two enlarged. Of the 12 PCLs that did not disappear, 10 PCLs disappeared at long-term follow-up, except for two reduced PCLs were not re-examined. Logistic regression analysis showed that drinking history was an independent risk factor, age ≥ 65 years was an independent protective factor for PCLs complicating AIP. other: No other

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Endoscopic ultrasonography-guided drainage for spontaneous rupture of a pancreatic pseudocyst into the peritoneal cavity in a patient with autoimmune pancreatitis

Cited by 5 publications

References 10 publications

Steroid therapy has an acceptable role as the initial treatment in autoimmune pancreatitis patients with pancreatic cyst formation: Based on a Japanese nationwide study

Steroid therapy has an acceptable role as the initial treatment in autoimmune pancreatitis patients with pancreatic cyst formation: Based on a Japanese nationwide study

Spleen and Peritoneal Cavity

Imaging Features and Risk Factors of Pancreatic Cystic Lesions Complicating Autoimmune Pancreatitis: A Retrospective Study

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