Pancreaticopleural fistula (PPF) a fistulous connection between the pancreas and pleural space due to prolonged chronic pancreatitis (CP). PPF is a very rare complication which presents in 0.4% of chronic pancreatitis cases, especially among children. We report a case involving a 3-year-old boy who presented with pleural effusion caused by a PPF, a complication of hereditary pancreatitis, which was, for the first time in Korea, successfully managed with endoscopic treatment. Chest radiography and computed tomography showed massive pleural effusion. Percutaneous catheter drainage was performed. High amylase levels were observed in the pleural fluid and serum, suggesting PPF. The patient was managed with bowel rest and octreotide infusion. Endoscopic retrograde cholangiopancreatography revealed CP, and pleural effusion was successfully managed with stent placement. PRSS1 genetic screening revealed R122H mutation.
Amylases ; Catheters ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Fistula ; Genetic Testing ; Humans ; Korea ; Male ; Octreotide ; Pancreas ; Pancreatic Fistula ; Pancreatitis ; Pancreatitis, Chronic ; Pleural Effusion ; Radiography ; Stents ; Thorax

Candida is a commensal organism that is frequently found in the human gastrointestinal tract. It is the most common organism that causes pancreatic fungal infections. However, magnetic resonance imaging findings of Candida infection in the pancreas have not been described. We report imaging findings of pancreatic candidiasis in a patient in immunocompetent condition. It presented as a multi-septated cystic mass with a peripheral solid component in the background of pancreatitis and restricted diffusion on diffusion-weighted image that mimicked a malignant pancreatic cystic tumor.
Candida/pathogenicity ; Candidiasis/*diagnosis/microbiology/radiography ; Diagnosis, Differential ; Humans ; Immunocompromised Host ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Pancreatic Neoplasms/*diagnosis/radiography ; Pancreatitis/*diagnosis/microbiology/radiography

Since the introduction of pancreas transplantation more than 40 years ago, surgical techniques and immunosuppressive regiments have improved and both have contributed to increase the number and success rate of this procedure. However, graft survival corresponds to early diagnosis of organ-related complications. Thus, knowledge of the transplantation procedure and postoperative image anatomy are basic requirements for radiologists. In this article, we demonstrate the imaging spectrum of pancreas transplantation with enteric exocrine drainage.
Adult ; Anastomosis, Surgical/methods ; Diagnostic Imaging/methods ; Drainage/methods ; Female ; Graft Rejection/pathology ; Graft Survival ; Humans ; Iliac Artery/radiography/surgery ; Immunosuppressive Agents ; Kidney Transplantation ; Male ; *Medical Illustration ; Mesenteric Artery, Superior/radiography/surgery ; Middle Aged ; Pancreas/*blood supply/radiography ; Pancreas Transplantation/adverse effects/*methods ; Pancreatitis, Graft/etiology ; Portal Vein/radiography/surgery ; Postoperative Complications/radiography ; Postoperative Hemorrhage/etiology ; Survival Rate

No abstract available.
Acute Disease ; Adult ; Cholangiopancreatography, Endoscopic Retrograde ; Colon, Transverse/*radiography ; Colonic Diseases/*diagnosis/etiology ; Colonoscopy ; Constriction, Pathologic ; Humans ; Male ; Pancreatitis/complications/*diagnosis ; Tomography, X-Ray Computed

Hepatic portal venous gas (HPVG) has been considered a rare entity associated with a poor prognosis. Portal vein gas is most commonly caused by mesenteric ischemia but may have a variety other causes. HPVG can be associated with ischemic bowel disease, inflammatory bowel disease, intra-abdominal abscess, small bowel obstruction, acute pancreatitis, and gastric ulcer. Because of high mortality rate, most HPVG requires emergent surgical interventions and intensive medical management. We experienced a case of hepatic portal venous gas caused by acute pancreatitis and successfully treated with medical management.
Acute Disease ; Anti-Bacterial Agents/therapeutic use ; Gases/metabolism ; Humans ; Male ; Middle Aged ; Pancreatitis/*diagnosis/drug therapy/radiography ; Portal Vein/radiography ; Tomography, X-Ray Computed ; Vascular Diseases/*diagnosis/drug therapy/radiography

Splenic pseudocyst is a rare disease associated with chronic and acute pancreatitis splenic pseudocyst is treated by distal pancreatectomy and splenectomy. A 47-year old woman with a 10-year history of alcohol abuse presented with epigastric and left upper quadrant pain of 3 days duration. Abdominal CT showed a 4.0x4.5 cm sized cystic lesion in the tail of the pancreas. Analgesics was administrated for the relief of abdominal pain. On the 4th hospital day, the patient complained more of left upper quadrant pain, so we took follow up CT scans. On follow up CT, one large splenic pseudocyst with size of 9.5x4.5x10.0 cm was noted. The patient was treated conservatively by percutaneous catheter drainage and discharged on the 13th hospital day. This case is the first case report of splenic pseudocyst treated conservatively, not by surgery in Korea.
Acute Disease ; Alcoholism/diagnosis ; Drainage ; Female ; Humans ; Middle Aged ; Pancreatic Pseudocyst/diagnosis ; Pancreatitis/*complications ; Splenic Diseases/etiology/*radiography/ultrasonography ; Tomography, X-Ray Computed

Abdominal Pain ; diagnosis ; diagnostic imaging ; Back Pain ; diagnosis ; diagnostic imaging ; Humans ; Male ; Pancreatitis ; diagnosis ; diagnostic imaging ; Radiography ; Recurrence ; Young Adult

No abstract available.
Acute Disease ; Amylases/blood ; Humans ; Hyperamylasemia/complications/*diagnosis ; Isoenzymes/analysis ; Liver Cirrhosis/complications/diagnosis ; Male ; Middle Aged ; Pancreatitis/complications/*diagnosis/radiography ; Tomography, X-Ray Computed

No abstract available.
Autoimmune Diseases/*diagnosis/drug therapy/immunology ; Azathioprine/therapeutic use ; Common Bile Duct/pathology ; Emphysema ; Fibrosis ; Humans ; Immunoglobulin G/blood ; Immunosuppressive Agents/therapeutic use ; Lung/*radiography ; Male ; Middle Aged ; Pancreatitis/*diagnosis/drug therapy/immunology ; Stents ; Tomography, X-Ray Computed

BACKGROUND/AIMS: The aim of this study is to assess serum procalcitonin (PCT) for early prediction of severe acute pancreatitis compared with multiple scoring systems and biomarkers. METHODS: Forty-four patients with acute pancreatitis confirmed by radiological evidences, laboratory assessments, and clinical manifestation were prospectively enrolled. All blood samples and image studies were obtained within 24 hours of admission. RESULTS: Acute pancreatitis was graded as severe in 19 patients and mild in 25 patients according to the Atlanta criteria. Levels of serum PCT were significantly higher in severe acute pancreatitis (p=0.001). The accuracy of serum PCT as a predicting marker was 77.3%, which was similar to the acute physiology and chronic health examination (APACHE)-II score, worse than the Ranson score (93.2%) and better than the Balthazar CT index (65.9%). The most effective cut-off level of serum PCT was estimated at 1.77 ng/mL (AUC=0.797, 95% CI=0.658-0.935). In comparision to other simple biomarkers, serum PCT had more accurate value (77.3%) than C-reactive protein (68.2%), urea (75.0%) and lactic dehydrogenase (72.7%). Logistic regression analysis revealed that serum PCT has statistical significance in acute severe pancreatitis. Assessment of serum PCT levels and length of hospital stay by simple linear regression analysis revealed effective p-value with low R square level, which could make only possibilty for affection of serum PCT to admission duration (r2=0.127, p=0.021). CONCLUSIONS: Serum PCT was a promising simple biomarker and had similar accuracy of APACHE-II scores as predicting severity of acute pancreatitis.
APACHE ; Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Biological Markers/blood ; C-Reactive Protein/analysis ; Calcitonin/*blood ; Female ; Humans ; L-Lactate Dehydrogenase/blood ; Length of Stay ; Logistic Models ; Male ; Middle Aged ; Pancreatitis/*diagnosis/pathology/radiography ; Predictive Value of Tests ; Protein Precursors/*blood ; *Severity of Illness Index ; Urea/blood