Medicina, Vol. 59 No. 1, 2023.
Studija slučaja
https://doi.org/10.21860/medflum2023_292456
Intestinal Perforation Due to the Compressive Effect of Pancreatic Pseudocyst – A Case Report
Iva Šimić
orcid.org/0009-0009-2771-9430
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska
Goran Hauser
; Sveučilište u Rijeci, Medicinski fakultet, Rijeka, Hrvatska, Klinički bolnički centar Rijeka, Klinika za internu medicinu, Zavod za gastroenterologiju, Rijeka, Hrvatska
Sažetak
Aim: To present a specific complication of chronic pancreatitis which is perforation of the small intestine due to the compressive effect of pseudocysts, and different ways of diagnosis and treatment of the same. Case report: A 60-year-old man was admitted to the emergency room due to diffuse abdominal pain and profuse vomiting of dark brown contents. Physical examination revealed palpatory abdominal wall pain and abdominal defanse. During hospitalization, a CT of the abdomen was made, which indicated an exacerbation of chronic pancreatitis.As a support of the exacerbation of chronic pancreatitis, s a large cystic formation (195x109x158mm) well limited was found, filled with denser content in gravity-dependent parts. A drain was placed in the pseudocyst for continuous emptying. After percutaneous drainage, a pseudocyst measuring 21x18mm persisted and made communication with a smaller cystic formation from the bursa omentalis. The next day, two pancreatic prosthesis were placed by ERCP technique due to stenosed ductus pancreaticus at the junction between the head and tail of the pancreas. Prior to the patient’s discharge, US of the abdomen showed a residual pseudocyst measuring 30x30mm. One week after discharge, the pacient came back to emergency room because of the vomiting, decressed appetite and energy, and weight loss. Further examinations revealed a perforation of the small intestine as the resault of adhesive ileus and peritonitis. The patient’s condition worsened in two days and he was described as anergic with decreased state of consciousness and he died that day in the intensive care unit. Conclusion: A pseudocyst that grows despite therapeutic procedures, and the symptoms and signs of ileus in the exacerbation of chronic pancreatitis should raise suspicion of compression disorders of cystic formation in the abdomen.
Ključne riječi
ileus; intestinal perforation; pancreatic pseudocyst; pancreatitis; peritonitis
Hrčak ID:
292456
URI
Datum izdavanja:
1.3.2023.
Posjeta: 869 *