1.Endoscopic Management of Pancreaticopleural Fistula in a Child with Hereditary Pancreatitis
Dahye LEE ; Eun Joo LEE ; Ju Whi KIM ; Jin Soo MOON ; Yong Tae KIM ; Jae Sung KO
Pediatric Gastroenterology, Hepatology & Nutrition 2019;22(6):601-607
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
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Catheters
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Child
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Child, Preschool
;
Cholangiopancreatography, Endoscopic Retrograde
;
Drainage
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Fistula
;
Genetic Testing
;
Humans
;
Korea
;
Male
;
Octreotide
;
Pancreas
;
Pancreatic Fistula
;
Pancreatitis
;
Pancreatitis, Chronic
;
Pleural Effusion
;
Radiography
;
Stents
;
Thorax
2.Pancreatic Candidiasis That Mimics a Malignant Pancreatic Cystic Tumor on Magnetic Resonance Imaging: A Case Report in an Immunocompetent Patient.
Minjung SEONG ; Tae Wook KANG ; Sang Yun HA
Korean Journal of Radiology 2015;16(6):1253-1256
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
3.Imaging Spectrum after Pancreas Transplantation with Enteric Drainage.
Jian Ling CHEN ; Rheun Chuan LEE ; Yi Ming SHYR ; Sing E WANG ; Hsiuo Shan TSENG ; Hsin Kai WANG ; Shan Su HUANG ; Cheng Yen CHANG
Korean Journal of Radiology 2014;15(1):45-53
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
5.A Case of Successful Treatment of Portal Venous Gas Caused by Acute Pancreatitis.
Shi Heon DONG ; Hyeon Geun CHO ; Jeong Hoon BAEK ; Beo Deul KANG ; Mi Sung KIM ; Jae Hee CHO ; Jeong Hoon LEE ; Song Wook CHUN
The Korean Journal of Gastroenterology 2013;61(3):170-173
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
6.A Case of Splenic Pseudocyst Complicated by Acute Pancreatitis.
Han Na LEE ; Tae Hee LEE ; Ki Hyun RYU ; Sung Min RIM ; In Beom JEONG ; Yong Seok KIM ; Young Woo CHOI ; Young Woo KANG
The Korean Journal of Gastroenterology 2012;59(2):193-196
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
8.A Case of Acute Pancreatitis due to Afferent Loop Syndrome with Internal Hernia.
Jong Won PARK ; Jin Heon LEE ; Sung Jun KIM ; Hye Won PARK ; Hyoung Su KIM ; Woon Geon SHIN ; Kyung Ho KIM ; Hak Yang KIM
The Korean Journal of Gastroenterology 2011;57(3):194-197
Acute pancreatitis and afferent loop syndrome (ALS) have similar symptoms and physical findings. Accurate early diagnosis is essential, as the management of acute pancreatitis is predominantly conservative whereas ALS usually requires surgery. We experienced one case of pancreatitis due to ALS with internal hernia. Laboratory findings of patient showed elevated serum amylase, lipase and WBC count. One day after admission, diagnosis was modified as acute pancreatitis caused by ALS on computed tomography. Patient was managed with surgical treatment and operation finding revealed ALS due to internal hernia. He was recovered well after surgical treatment and discharged without significant sequelae.
Acute Disease
;
Afferent Loop Syndrome/complications/*diagnosis/surgery
;
Endoscopy, Gastrointestinal
;
Gallstones
;
Hernia, Abdominal/*complications
;
Humans
;
Male
;
Middle Aged
;
Pancreatitis/*diagnosis/etiology
;
Radiography, Abdominal
;
Tomography, X-Ray Computed
9.Spontaneous Dissolution of Isolated Superior Mesenteric Vein Thrombosis in Acute Pancreatitis.
Byung Soo NA ; Byung Min JOHN ; Ki Bum KIM ; Je Soo LEE ; Hyun Woo JO ; Chang Hyeon SEOCK ; Dong Hui KIM ; Ki Sung LEE
The Korean Journal of Gastroenterology 2011;57(1):38-41
Acute pancreatitis can result in many vascular complications in both artery and vein. Venous complication usually occurs as a form of splenic or portal vein thrombosis, and also can simultaneously occur in superior mesenteric vein as well. Rarely, isolated superior mesenteric vein thrombosis occurs as a venous complication. Although it is uncommon, mesenteric vein thrombosis is an important clinical entity because of the possibility of mesenteric ischemia and infarction of small bowel. The treatments of mesenteric venous thrombosis include anticoagulation therapy, transcatheter therapy and surgical intervention. We report a case of 45-year-old man who had acute pancreatitis with isolated superior mesenteric vein thrombosis, which was spontaneously dissolved with the resolution of underlying inflammation without anticoagulation or surgical intervention.
Acute Disease
;
Humans
;
Male
;
*Mesenteric Veins
;
Middle Aged
;
Pancreatitis/complications/*diagnosis
;
Tomography, X-Ray Computed
;
Venous Thrombosis/*diagnosis/etiology/radiography

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