We report a case of pancreatic pseudocyst presenting as an intramural gastric tumor on upper gastrointestinal examination, endoscopic ultrasound and computed tomography of the abdomen. Pancreatic pseudocysts in the stomach wall is rare and the most of them presented as a cystic mass, but this case was presented as a gastric mural solid tumor. Exploration revealed an about 4 4 2 cm sized round mass at the midbody of great curvature of stomach, it was in the muscle layer, and removed by surgical operation. The correct diagnosis of this case was established postoperately on the pathologic examination revealed pancreatic pseudocyst.
Abdomen ; Diagnosis ; Pancreatic Pseudocyst* ; Stomach ; Ultrasonography

Branch duct intraductal papillary mucinous neoplasms (BD-IPMNs) are characterized by cystic dilation of secondary ducts clearly communicating with a normal-sized main pancreatic duct and seem to have a less aggressive clinical course than those arising from the main duct. BD-IPMNs are related to pancreatitis but the causal relationship is unclear. We report a case of a 62-year-old woman initially thought to have pseudocysts complicated by idiopathic recurrent pancreatitis but was finally diagnosed with BD-IPMN leading to recurrent acute pancreatitis attacks. The patient had six episodes of acute pancreatitis over 5 years. An abdominal computed tomography scan revealed two cystic lesions of 2.0 and 1.5 cm in the pancreatic body, which appeared at the second episode of acute pancreatitis. Each pancreatitis episode improved with conservative treatment, but the cystic lesions increased in size to 2.5 and 3.5 cm during the late follow-up period. A distal pancreatectomy was performed under the diagnosis of recurrent pancreatitis caused by BD-IPMN. The pathological findings revealed BD-IPMN with moderate dysplasia. We herein present a case of BD-IPMN mimicking pancreatic pseudocysts with a review of the literature.
Diagnosis ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Mucins* ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreatic Pseudocyst ; Pancreatitis*

The experience in diagnosis and treatment of bleeding complications in severe acute pancreatitis (SAP) by transcatheter arterial embolization was summarized. The clinical data of 19 SAP patients complicated with intra-abdominal bleeding in our hospital from Jan. 2000 to Jan. 2003 were analyzed retrospectively and the therapeutic outcome of TAE was evaluated statistically. The results showed that the short-term successful rate of hemostasis by TAE was 89.5% (17/19), the incidence of re-bleeding after TAE was 36.8% (7/19) and the successful rate of hemostatis by second TAE was 71.4% (5/7). It was concluded that the intra-abdominal bleeding in SAP was mainly caused by the rupture of erosive/infected pseudoaneurysm. Mostly, the broken vessels were splenic artery and gastroduodenal artery; In terms of emergence hemostatis, TAE is the most effective method. Surgical hemostasis is necessary if hemostasis by TAE is failed or re-bleeding occurs after TAE.
Aneurysm, False/diagnosis ; Aneurysm, False/etiology ; Aneurysm, False/therapy ; *Embolization, Therapeutic/methods ; Hemoperitoneum/diagnosis ; Hemoperitoneum/etiology ; Hemoperitoneum/*therapy ; Pancreatic Pseudocyst/diagnosis ; Pancreatic Pseudocyst/etiology ; Pancreatic Pseudocyst/therapy ; Pancreatitis, Acute Necrotizing/*complications ; Pancreatitis, Acute Necrotizing/therapy ; Retrospective Studies

Pancreatic cystic lesions include retention cysts (congenital cysts), pseudocysts, and cystic neoplasms. Pancreatic cystic neoplasms have recently been diagnosed more commonly, possibly due to advances in imaging and widespread screening programs. Cystic neoplasms of the pancreas account for 10-20% of pancreatic tumors. Mucinous cystic neoplasms (MCN) and intraductal papillary mucinous neoplasms are regarded as premalignant lesions, whereas serous cystadenoma is not. In the clinical setting of acute pancreatitis, pancreatic cystic lesions are usually diagnosed as pseudocysts. However, cystic neoplasms of the pancreas should be considered in the differential diagnosis of pancreatic cysts, even in patients with a history of pancreatitis. In the Korean literature, MCN combined with acute pancreatitis has rarely been reported. Here, we report a case of MCN presenting with acute pancreatitis in a 22-year-old female, which was initially misdiagnosed as pancreatic pseudocyst.
Cystadenoma, Serous ; Diagnosis, Differential ; Female ; Humans ; Mass Screening ; Mucins* ; Pancreas* ; Pancreatic Cyst ; Pancreatic Neoplasms ; Pancreatic Pseudocyst ; Pancreatitis* ; Young Adult

Pancreatic injuries due to trauma in children are rare. An early diagnosis is difficult as the signs and symptoms are insidious, but delays in diagnosis can lead to significant complications. We report a case of a child who visited the emergency department with aggravating abdominal pain. The physicians first diagnosed the abdominal pain as being caused by a disease in the emergency department, but the patient was subsequently diagnosed with pancreatic injury. Clinicians should be aware of a possible trauma in children who complain of vague abdominal pain even in the absence of corresponding history.
Abdominal Pain ; Amylases ; Child ; Diagnosis ; Early Diagnosis ; Emergencies ; Emergency Service, Hospital ; Humans ; Lipase ; Pancreas ; Pancreatic Pseudocyst

BACKGROUND: A pancreatic pseudocyst is one of various complications occurring in acute of chronic pancreatitis. It is usually located in the retroperitoneal space near the pancreas. However, other unusual locations are also possible. Jones intially described the mediastinal pseudocyst in 1940. Since then, fewer than 50 cases have been reported. A diagnosis of a mediastinal pseudocyst is accomplished by imaging studies revealing the cystic nature of the mass with evidences of acute or chronic pancreatitis. There is some controversy regarding the appropriate management of mediastinal pseudocyst because of the high mortality and morbidity after surgical management. Here we report a case of a mediastinal pancreatic pseudocyst found in a patient with asymptomatic alcohol-related pancreatitis complicated by the development of a mediastinal peudocyst, which quickly resolved after endoscopic retrograde pancreatic and biliary drainage and subcutaneous injection of a somatostatin analog(octreotide acetate) without any complications.
Diagnosis ; Drainage ; Humans ; Injections, Subcutaneous ; Mortality ; Pancreas ; Pancreatic Pseudocyst* ; Pancreatitis ; Pancreatitis, Chronic ; Retroperitoneal Space ; Somatostatin

PURPOSE: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries. METHODS: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed. RESULTS: Age of the patients ranged from 3–11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children. Only 3 patients had associated injuries and all were haemodynamically stable. Serum amylase levels were raised in 12 patients at admission which ranged from 400–1,000 IU. Computed tomography scan made a correct diagnosis in 14 patients. Grades of the injury varied from grade I–V (1, 3, 6, 4, 1 patients respectively). Fourteen patients were managed conservatively. One patient underwent laparotomy for suspected superior mesenteric hematoma. The average duration of enteral feeds was 3.7 days and of hospital stay was 9.4 days. Six patients formed pancreatic pseudocysts; two were managed conservatively while the other four underwent cystogastrostomy. The patients were followed up for a period of 1–12 years. All remained asymptomatic and none had exocrine or endocrine deficiencies. CONCLUSION: Non-operative treatment for isolated blunt trauma of pancreas in children may be safely followed for all the grades of injury; if associated injuries requiring surgical intervention are ruled out with a good quality imaging and the patients are hemodynamically stable. It did not increase the hospital stay and morbidity and avoided operative intervention on acutely injured pancreas.
Amylases ; Child* ; Diagnosis ; Hematoma ; Humans ; Laparotomy ; Length of Stay ; Pancreas* ; Pancreatic Pseudocyst ; Retrospective Studies

PURPOSE: Blunt trauma of pancreas in children is uncommon and its management varies from observational to early operative intervention. We analysed the feasibility and outcome of non-operative management in all grades of paediatric pancreatic injuries. METHODS: A total of 15 patients of pancreatic trauma seen in a Paediatric Surgery Unit were retrospectively analyzed. RESULTS: Age of the patients ranged from 3–11 years (mean, 7.7 years). The mode of injury was local trauma in 9 children. Only 3 patients had associated injuries and all were haemodynamically stable. Serum amylase levels were raised in 12 patients at admission which ranged from 400–1,000 IU. Computed tomography scan made a correct diagnosis in 14 patients. Grades of the injury varied from grade I–V (1, 3, 6, 4, 1 patients respectively). Fourteen patients were managed conservatively. One patient underwent laparotomy for suspected superior mesenteric hematoma. The average duration of enteral feeds was 3.7 days and of hospital stay was 9.4 days. Six patients formed pancreatic pseudocysts; two were managed conservatively while the other four underwent cystogastrostomy. The patients were followed up for a period of 1–12 years. All remained asymptomatic and none had exocrine or endocrine deficiencies. CONCLUSION: Non-operative treatment for isolated blunt trauma of pancreas in children may be safely followed for all the grades of injury; if associated injuries requiring surgical intervention are ruled out with a good quality imaging and the patients are hemodynamically stable. It did not increase the hospital stay and morbidity and avoided operative intervention on acutely injured pancreas.
Amylases ; Child* ; Diagnosis ; Hematoma ; Humans ; Laparotomy ; Length of Stay ; Pancreas* ; Pancreatic Pseudocyst ; Retrospective Studies

The pathogenesis of pancreatic pseudocyst is still not understood. A 5-year-old, 24-kg intact female Shetland Sheepdog was presented with anorexia and vomiting. Diagnostic imaging tests revealed that the left limb of the pancreas was thickened and contained two cystic lesions (6.3 × 5.6 × 4 cm³ and 3.5 × 4.6 × 5.5 cm³). During the laparotomy, lesions were opened with de-roofing of superabundant tissue, and omentalization was performed. The dog recovered uneventfully after surgery and was discharged on postoperative day 12. Histopathologically, it was diagnosed as chronic pancreatic pseudocyst. This case report describes the diagnosis and successful omentalization of pancreatic pseudocysts in a dog.
Animals ; Anorexia ; Child, Preschool ; Diagnosis ; Diagnostic Imaging ; Dogs ; Extremities ; Female ; Humans ; Laparotomy ; Pancreas ; Pancreatic Pseudocyst ; Vomiting

Diagnoses of cystic lesions in the pancreas are increasing in clinical practice because of the wider use of imaging studies. The selection of appropriate treatment depends on the ability to distinguish between benign and malignant cysts. However, cystic pancreatic neoplasms sometimes misdiagnosed as pseudocysts, and managed incorrectly. We report herein the case of a pancreatic mucinous cystadenoma, misdiagnosed as a pseudocyst and managed by internal drainage. A 36-year-old woman initially had a cystojejunostomy under the diagnosis of a pseudocyst, but subsequently suffered from epigastric pain and fever due to cyst infection. A distal pancreatectomy, encompassing the previous cystojejunostomy anastomosis site, was performed 2 years after the initial operation and a mucinous cystadenoma was confirmed by histopathologic examination. Although pseudocysts are predominantly cystic lesions in the pancreas, cystic neoplasms should be considered before deciding the treatment strategy because the misdiagnosis a cystic neoplasm as a pseudocyst may result in serious problems.
Adult ; Cystadenoma, Mucinous* ; Diagnosis ; Diagnostic Errors ; Drainage* ; Female ; Fever ; Humans ; Mucins* ; Pancreas ; Pancreatectomy ; Pancreatic Neoplasms ; Pancreatic Pseudocyst*