Fremdkörpergranulom des Pankreaskopfes durch eine Fischgräte – eine sehr seltene Differentialdiagnose des Pankreaskopftumors

Junghans, R.; Schümann, Uwe; Finn, Heather; Riedel, Ulrike

doi:10.1007/pl00002582

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Furthermore, deep penetration into the pancreatic parenchyma would likely result in injury to the main or peripheral pancreatic ducts, leading to acute pancreatitis or potentially causing obstruction of the main pancreatic duct, which could result in chronic pancreatitis or atrophy of the pancreatic tail. Dissection of adjacent small or large vessels would also be anticipated, potentially leading to retroperitoneal hemorrhage 54,65 . In some cases, such severe vascular injury can even be fatal 59 .…”

Section: Discussionmentioning

confidence: 99%

“…It is estimated that around 1% of swallowed foreign bodies penetrate the gastric and duodenal wall, traveling within the abdominal cavity and potentially reaching the liver, pancreas, spleen or even further into the thoracic cavity. 28,33 Our literature review revealed 41 cases of intrapancreatic foreign bodies (Table 3), including 14 suture needles, [23][24][25][26][27][28][29][30][31] 4 metal wires, [32][33][34][35] 19 fish bones, 7,[36][37][38][39][40][41][42][43][44][45][46][47][49][50][51][52][53][54] 2 other pointed bones 55,56, and 2 toothpicks. 57,58 All these foreign bodies are believed to have migrated from the stomach or the duodenum.…”

Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

“…57,58 All these foreign bodies are believed to have migrated from the stomach or the duodenum. Most cases became symptomatic within days or weeks, resulting from complications such as abscess formation, 32,[38][39][40][41]51,[54][55][56][57][58] hematoma, 53 pseudoaneurysm, and acute to chronic pancreatitis with high morbidity and mortality. 23,39,41,47,57 However, in 4 cases involving ingested sewing needles lodged in the pancreas, 30,31 no clinical symptoms were noted and the patients were treated conservatively.…”

Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

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Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Foreign bodies within the pleura and pancreas are infrequent, and the approaches to their treatment still a subject of debate. There is limited knowledge particularly regarding glass foreign bodies. Methods: We present a case involving large glass splinters in the pleura and pancreas, with an unknown entry point. In addition, a systematic review was conducted to explore entry hypotheses and management options. Results: In addition to our case, our review uncovered eight incidents of intrapleural glass, and another eight cases of glass in other intrathoracic areas. The fragments entered the body through impalement (81%), migrated through the diaphragm after impalement (6%), or caused transesophageal perforation (19%) following ingestion. Eight instances of glass inside the abdominal cavity were documented, with seven resulting from impalement injuries and one from transintestinal migration. There were no recorded instances of glass being discovered within the pancreas. Among the 41 nonglass intrapancreatic foreign bodies found, sewing needles (34%) and fish bones (46%) were the most common; following ingestion, they had migrated through either a transgastric or transduodenal perforation. In all these cases, how the foreign bodies were introduced was often poorly recalled by the patient. Many nonglass foreign bodies tend to become encapsulated by fibrous tissue, rendering them inert, though this is less common with glass. Glass has been reported to migrate through various tissues and cavities, sometimes with a significant delay spanning even decades. There are cases of intrapleural migration of glass causing hemothorax, pneumothorax, and heart and major blood vessels injury. For intrapleural glass fragment management, thoracoscopy proved to be effective in 5 reported cases, in addition to our patient. Most intrapancreatic nonglass foreign bodies tend to trigger pancreatitis and abscess formation, necessitating management ranging from laparoscopic procedures to subtotal pancreatectomy. There have been only four documented cases of intrapancreatic needles that remained asymptomatic with conservative management. There is no direct guidance from the existing literature regarding management of intrapancreatic glass foreign bodies. Consequently, our patient is under observation with regular follow-ups and has remained asymptomatic for the past 2 years. Conclusions: Glass foreign bodies in the pleura are rare, and our report of an intrapancreatic glass fragment is the first of its kind. Impalement is the most likely method of introduction. As glass has significant migration and an ensuing complication potential, preventive removal of intrapleural loose glass should be considered. However, intrapancreatic glass fragment management remains uncertain.

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Section: Discussionmentioning

confidence: 99%

Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

Section: Hypothesis Of Earlier Ingestionmentioning

confidence: 99%

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Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Ehrsam,

Meier Adamenko,

Schlumpf

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…In clinical practice, abdominal foreign bodies become fiber-wrapped due to inflammation caused by the formation of lumps, and misdiagnosis is not uncommon [ 10 ]. Items such as legacy gauze [ 11 ], surgical sutures [ 12 ], and fish and chicken bones penetrating into the abdominal cavity [ 13 , 14 ] have formed tumors.…”

Section: Discussionmentioning

confidence: 99%

Fluorouracil implants caused a diaphragmatic tumor to be misdiagnosed as liver metastasis: a case report

et al. 2016

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BackgroundFluorouracil implants are widely used in peritoneal interstitial chemotherapy. Curative effects have been obtained, but implants have also caused some complications.Case presentationWe performed an analysis of a 66-year-old male patient’s case history, as well as conventional pathological analysis and Raman spectroscopic detection of the diaphragmatic tumor. We also analyzed the underlying causes of this condition to prevent complications and reduce misdiagnoses in future cases. The patient had a history of peritoneal fluorouracil implantation. Pathological analysis of the diaphragmatic mass revealed foreign particles, and Raman detection showed that the mass contained fluorouracil.ConclusionFluorouracil implants may persist due to the high concentrations of this drug used in peritoneal chemotherapy. This finding should provide guidance and improve the application of peritoneal implants. In clinical trials, and the diagnosis of liver metastasis should be based on pathological results.

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“…In der Literatur wird ein Fremdkörpergranulom als Ursache eines Pankreaskopftumors beschrieben [9]. Im eigenen Krankengut führte eine Strahlenfibrose der Bauchspeicheldrüse zur operativen Exploration.…”

Section: Einteilung Der Pankreasneoplasienunclassified

Seltene Befunde am Pankreas

Hohmann

Schramm²

2003

Zentralbl Chir

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From 1984 to 2001, 486 operations were carried out at the surgical clinic in Gera for pancreatic neoplasms, including 49 patients with rare neoplasms of the pancreas. In 23 patients malignant pancreatic tumors were present (9 solitary metastases, 9 endocrine carcinomas, 2 cystadenocarcinomas, 2 schwannomas and one non-Hodgkin's lymphoma). In 28 benign lesions a resection of the tumor was performed, concerning 8 insulinomas, 8 serous cystadenomas, 3 mucinous cystadenomas and 4 rare cystic tumors. A sarcoidosis, an autoimmune pancreatitis and a radiation fibrosis were diagnosed in 3 patients operated under the suspicion of a malignant pancreatic tumor. By means of own case examples and data from the literature these rare entities are described with their diagnostic and therapeutic special features.

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Fremdkörpergranulom des Pankreaskopfes durch eine Fischgräte – eine sehr seltene Differentialdiagnose des Pankreaskopftumors

Cited by 12 publications

References 11 publications

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Foreign Glass Bodies in Pleura and Pancreas: Systematic Review for Entry Hypotheses and Treatment Options in an Unresolved Case

Fluorouracil implants caused a diaphragmatic tumor to be misdiagnosed as liver metastasis: a case report

Seltene Befunde am Pankreas

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