Spontaneous perforation of a pancreatic pseudocyst into the colon and duodenum

Shatney, Clayton H.; Sosin, Henry

doi:10.1016/s0002-9610(73)80140-0

Cited by 45 publications

(13 citation statements)

References 10 publications

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“…Benign causes reported include benign duodenal ulceration [13], Crohn's disease [14][15][16][17][18], gallstones [19][20][21], a pancreatic pseudocyst rupture [22][23][24] and stent migration [3]. Rarer causes have been noted due to tuberculous disease, typhoid ulceration, non specific inflammatory lesions and secondary to complicated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Malignant Coloduodenal Fistulas-Review of Literature and Case Report

Majeed

Agarwal

Shilpa

et al. 2011

Indian J Surg Oncol

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Colo-duodenal fistula is an uncommon complication of malignant and inflammatory bowel disease. Presentation varies from upper abdominal pain, feculent vomiting and diarrhea associated with foul eructation's. Occasionally patients presents with gastro-intestinal bleed. The contact of duodenal bile salts with colonic mucosa frequently leads to diarrhea, so also duodenal colonization with colonic pathogens frequently leads to malabsorption and severe foul eructations. The diagnosis is established either by gastrointestinal contrast studies or contrast enhanced C. T. Scan. Gastroduodenoscopy can demonstrate the fistulous communication or direct invasion and it can also be helpful in obtaining a histological diagnosis. Surgical treatment includes Right Radical hemicolectomy combined with Pancreatico duodenectomy in operable patients and Intestinal bypass for inoperable ones.Right Radical hemicolectomy combined with wedge excision of Duodenum is a suitable alternative in select cases. We report an unusual case of locally advanced carcinoma hepatic flexure of colon with direct invasion of duodenum. Extended right radical hemicolectomy with wedge excision of second part of duodenum was done as an alternative to combined radical hemicolectomy with Pancreatico duodenectomy.

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Section: Discussionmentioning

confidence: 99%

Malignant Coloduodenal Fistulas-Review of Literature and Case Report

Majeed

Agarwal

Shilpa

et al. 2011

Indian J Surg Oncol

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“…Spontaneous perforation of pseudocysts into a hollow abdominal viscus is also known [5], One can postulate then that in our patient the posterior serosa of the stom ach was breeched early in the course of inflammation and attachment so that the path of least resistance then became the plane between the serosa and the muscular layers of the stomach.…”

Section: Discussionmentioning

confidence: 64%

Annular Pancreatic Pseudocyst Causing Gastric Outlet Obstruction and Esophageal Reflux

Aufiero¹,

Martin²

1985

Dig Surg

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Obstruction of the stomach or of the duodenum as a result of inflammatory pancreatic disease occurs in approximately 1 % of patients who develop pancreatitis. Duodenal compression is usually the cause of anatomic obstruction. We present a patient who developed anatomic gastric outlet obstruction, reflux esophagitis, and a severe motor disorder of the esophagus due to an annular pancreatic pseudocyst that totally surrounded the distal antrum. After draining the pseudocyst, the symptoms of gastric outlet obstruction and reflux esophagitis resolved, but the esophageal motor disorder persisted. Pseudocyst formation can present in unusual ways and must be considered in the differential diagnosis of gastric outlet obstruction and esophageal reflux. Persistence of the esophageal motor disorder suggests that peristalsis of the distal esophagus is a myogenic function.

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“…and into the pancreatic duct (n = 1), the latter presenting as haemoductus pancreaticus with melena [3 3 ] . Colonic fistulae are combined with significant morbidity and mor tality [13,[36][37][38], There is no benefit of the 'spontaneous drainage' and uncontrolled decompression of the pseudocyst into the colon, rather a high incidence of infectious and hemorrhagic complications occurs [ 3 9 ], Morbidity was 50% in the 'pancreatic' bleeding sub group when compared to the 20% rate in the 'nonpancreatic' bleeders, and the 30-day mortality was 7% in the 'nonpancreatic' but 50% (5 of 10) in the 'pancreatic' bleeding subgroup. Five of the six deaths occurred in this 'pancreatic' bleeding subgroup.…”

Section: Discussionmentioning

confidence: 99%

Vascular Complications in Chronic Pancreatitis

Seiler¹,

Boss²,

Czerniak³

et al. 1997

Dig Surg

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Vascular complications in chronic pancreatitis are not common, but once they occur they may be life-threatening and difficult to treat. There is a lack of classification that would help us to identify these patients at risk who may benefit from timely intervention and adequate treatment. The aim of the study is to analyze this question and to present a classification system of vascular complications in chronic pancreatitis. 154 patients with chronic pancreatitis treated during the 15-year period 1977-1992 were analyzed in this study. 73 patients treated before 1986 have been analyzed retrospectively. The remaining 81 patients were studied prospectively according to a defined protocol. 72 vascular lesions occurred in 46 of the 154 patients (30%). 21 patients had ‘nonbleeding’ (group I) vascular complications mainly due to venous thrombosis or compression. 25 patients suffered from bleeding complications (group II) and were further divided into ‘nonpancreatic’ versus ‘pancreatic’ bleeding subgroups. Comparing morbidity and mortality in group I and group II, we found a low morbidity and a zero mortality in group I as compared with a 32% morbidity and a 24% mortality in group II. Further comparing the ‘nonpancreatic’ and the ‘pancreatic’ bleeding subgroups, ‘nonpancreatic’ bleeders showed low morbidity and mortality as compared with a 50% morbidity and a 50% mortality in the ‘pancreatic’ bleeder subgroup. Indeed, 83% of all deaths with vascular complications occurred in this ‘pancreatic’ bleeder subgroup. Pancreatic bleedings also showed a high coincidence with pancreatic pseudocyst formation and fistula formation. This proposed classification concept of vascular lesions in chronic pancreatitis enables the detection of truly high-risk patients for severe complications and, therefore, those who may benefit from timely intervention before a potential life-threatening evolution has begun.

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Spontaneous perforation of a pancreatic pseudocyst into the colon and duodenum

Cited by 45 publications

References 10 publications

Malignant Coloduodenal Fistulas-Review of Literature and Case Report

Malignant Coloduodenal Fistulas-Review of Literature and Case Report

Annular Pancreatic Pseudocyst Causing Gastric Outlet Obstruction and Esophageal Reflux

Vascular Complications in Chronic Pancreatitis

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