Congenital pancreatic cyst arising from occlusion of the pancreatic
duct.
Pediatr Surg Int. 2007 Jun 7;
Congenital
pancreatic cysts, particularly solitary cysts, are rare causes of
abdominal masses in newborns. The etiology of these cysts is unknown
and they can vary in location within the pancreas. We present a novel
case of an infant with a solitary congenital cyst of the pancreatic
duct, itself, as a result of occlusion of the pancreatic duct.
Solitary congenital pancreatic cysts are a rare cause of abdominal
masses in infants. We recently evaluated a 7-week-old infant with
progressive abdominal distension since birth. This child was found to
have a large solitary pancreatic cyst. This cyst resulted from
occlusion of the main pancreatic duct at the level of the ampulla
resulting in cystic degeneration of the pancreatic duct. Based on our
review of the literature we believe this is the first documented case
of such a cyst.
Pancreatic
pseudocyst development due to organophosphate poisoning.
Turk J Gastroenterol. 2007 Jun;18(2):122-125.
Background/aims: Acute pancreatitis is a serious complication of
organophosphate poisoning. There is no report in the literature
dealing with the development of a pancreatic pseudocyst after
complication of organophosphate-induced acute pancreatitis. Therefore,
we present a case who developed pancreatic pseudocyst after
complication of organophosphate-induced acute pancreatitis. Methods: A
17-year-old female patient with a history of ingestion of complication
of organophosphate insecticide (DDVP EC 550, dichlorvos) was admitted
with cholinergic symptoms. On admission, serum amylase and lipase
levels were high and abdominal ultrasonography showed an edematous
pancreas. No etiological factor for acute pancreatitis was evident.
Results: We diagnosed complication of organophosphateinduced acute
pancreatitis. After four weeks, abdominal abdominal ultrasonography
and computerized tomography revealed a pancreatic pseudocyst of 6 cm
diameter. During follow-up, the pancreatic pseudocyst size regressed
to 4 cm. Conclusion: Complication of organophosphate poisoning can
cause acute pancreatitis and its complications. Early diagnosis and
appropriate treatment may reduce morbidity and mortality.
Congenital
true pancreatic cyst: a rare case.Diagn
Interv Radiol. 2006;12(1):31-3.
Congenital true
pancreatic cysts are very rarely seen in children. We report magnetic
resonance imaging features of a case of congenital true pancreatic
cyst with a high level of enzymatic activity which, to the best of our
knowledge, have not previously been reported. A 4-month-old boy was
admitted to our clinic with a history of abdominal swelling for one
month. A mobile, smooth, non-tender mass was palpated on the left side
of the abdomen during physical examination. Ultrasonography and MR
imaging revealed a bilocular cystic mass sized 9.5 x 8 x 6 cm. The
spleen was displaced superiorly, whereas the left kidney was displaced
posteriorly. Obliteration of the peripancreatic fat planes between the
cystic mass and tail of the pancreas was observed. During abdominal
surgical exploration, the pancreatic tail was larger than normal, and
a pancreatic cyst arising from the tail of the pancreas was observed.
Total cystectomy was performed with distal pancreatectomy. Although it
is extremely rare in children, congenital true pancreatic cysts should
be diagnostically considered in cases involving a cystic mass
neighboring the pancreas. MR imaging is not helpful in differential
diagnosis of other cysts originating from neighboring organs. Total
excision with distal pancreatectomy and splenic preservation are
advised for distal pancreatic cysts.
Non-neoplastic
cystic and cystic-like lesions of the pancreas: may mimic pancreatic
cystic neoplasms.ANZ
J Surg. 2006 May;76(5):325-31.
BACKGROUND:
Cystic lesions of the pancreas consist of a broad range of
pathological entities. With the exception of the pancreatic pseudocyst,
these are usually caused by pancreatic cystic neoplasms. Non-neoplastic
pancreatic cystic and cystic-like lesions are extremely rare. In the
present article, the surgical experience with these unusual entities
over a 14-year period is reported. METHODS: Between 1991 and 2004, all
patients who underwent surgical exploration for a cystic lesion of the
pancreas were retrospectively reviewed. Patients with a pancreatic
pseudocyst were excluded. There were 106 patients of whom 8 (7.5%) had
a final pathological diagnosis consistent with a non-neoplastic
pancreatic cystic or cystic-like lesion, including 3 patients with a
benign epithelial cyst, 2 with a pancreatic abscess (one tuberculous
and one foreign body), 2 with mucous retention cysts and 1 with a
mucinous non-neoplastic cyst. These eight patients are the focus of
this study. RESULTS: There were six female and two male patients with
a median age of 61.5 years (range, 41-71 years). All the patients were
of Asian origin including seven Chinese and one Indian. Four of the
patients were asymptomatic and their pancreatic cysts were discovered
incidentally on radiological imaging for other indications. All the
patients underwent preoperative radiological investigations, including
ultrasonography, computed tomography or magnetic resonance imaging,
which showed a cystic lesion of the pancreas. Three patients, all of
whom were symptomatic, were diagnosed preoperatively with a malignant
cystic neoplasm on the basis of radiological imaging. Two patients
were eventually found to have a pancreatic abscess, one tuberculous
and the other, secondary to foreign body perforation. The third
patient was found on final histology to have chronic pancreatitis with
retention cysts. The remaining five patients had a preoperative
diagnosis of an indeterminate cyst; on pathological examination, they
were found to have a benign epithelial (congenital) cyst (n = 3),
retention cyst (n = 1) and mucinous non-neoplastic cyst (n = 1). At a
median follow up of 20 months (range, 3-34 months), none of the
patients had any evidence of recurrent disease. CONCLUSION: Non-neoplastic
cystic and cystic-like lesions of the pancreas are rare causes of
pancreatic cystic lesions that are generally benign and do not require
surgery when asymptomatic. However, despite advances in diagnostic
investigations such as endoscopic ultrasound with fluid aspirate and
magnetic resonance imaging, the preoperative diagnosis remains
unreliable. Hence, the challenge for all clinicians is to recognize
these lesions preoperatively and to avoid 'unnecessary' surgery.
Three children
with pancreatic (pseudo)cysts as the cause of undefined abdominal pain.Ned
Tijdschr Geneeskd. 2006 Mar
4;150(9):500-4.
Three
children, two boys aged 5 years and one 2-year-old girl, who were
referred because of abdominal pain of variable duration, were found to
have cystic malformations that arose from the pancreas. In the first
boy, a traumatic pseudocyst was found that eventually turned out to
have been caused by child abuse. The second boy had pseudocysts
complicating chronic pancreatitis of presumably hereditary origin. In
the girl, a congenital pancreatic cyst was found. Pancreatic disease,
although rare, should be considered in the differential diagnosis of
abdominal pain in children.
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