Not Logged In     Login  
 Release 21.0, Jan 2008
 
Chapter : ch11. Hepatobiliary & Pancreas Section : Diagnosis and Prognosis of Pancreatitis
  Complications Associated with a Pancreatic Pseudocyst and Indications for Drainage

  Excel Sheet Reference
Copyright (c) 2006-2007, Institute for Algorithmic Medicine, Houston, TX, USA. All rights reserved.

Overview :

A pancreatic pseudocyst may form after acute or chronic pancreatitis, with development of a defined wall formed of granulation and fibrous tissue surrounding a fluid rich in pancreatic digestive enzymes. A pseudocyst may resolve on its own, or it may progress and cause complications.

 

Complications:

(1) rupture or chronic leakage. with ascites or pleural effusion

(2) compression or obstruction of stomach or duodenum, with persistent nausea and vomiting

(3) compression or obstruction of biliary drainage, with jaundice

(4) infection with or without abscess

(5) pseudoaneurysm with hemorrhage

(6) pain

(7) pancreatoenteric fistula

(8) splenic vein thrombosis

 

Indications for considering drainage (percutaneous, endoscopic or surgical):

(1) large size (> 6 cm) with no signs of regression after 6 or more weeks

(2) progressive increase in size

(3) infection

(4) bleeding

(5) clinical deterioration

(6) severe pain

(7) bowel or biliary obstruction

(8) pancreatopleural fistula

(9) severe pancreatic ascites

 

  References:

Bornman PC, Beckingham IJ. Chronic pancreatitis. BMJ. 2001; 322: 660-663.

Bradley EL III. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg. 1993; 128: 586-590.

Hsu J-T, Yeh C-N, et al. Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis. BMC Gastroenterol. 2006; 6.

Lam S, Bank S. Risk factors for morbidity and mortality in pancreatitis. Digestive Diseases. 1996; 14: 83-98.

Steer ML. Chapter 53: Exocrine pancreas. pages 1643-1678. IN: Townsend CM, Beauchamp RD, et al (editors). Sabiston Textbook of Surgery. The biological basis of modern surgical practice. 17th edition. Elsevier Saunders. 2004

 

 

   Excel Sheet | Reference TOP
     Pubmed Search For
Copy and paste the article title, or authors names into the search box