Abstract
BackgroundPancreatic tissue found in the mediastinum (both true ectopic and herniated pancreas) is rare. It becomes even more challenging when there are complications associated with this entity.Case presentationWe report an unusual case of pancreatic herniation into the mediastinum in a 90-year-old Caucasian female. This patient initially presented with nausea and vomiting associated with abdominal pain. Serum lipase and amylase both were elevated. Computed tomography scan of the chest, abdomen and pelvis revealed a large hiatal hernia with pancreas herniation into the mediastinum, with superimposed acute pancreatitis likely due to gallstone. Because of its unusual location, the patient also developed acute mediastinitis. The patient was management conservatively and did well. On the day of discharge; she was tolerating a diet, had no pain or nausea and was back to her baseline health.ConclusionAcute pancreatitis can be managed conservatively even if it is in the mediastinum. Also, ectopic or herniated pancreatic tissue is extremely rare and leads to unique clinical presentations, along with diagnostic and therapeutic challenges. Clinicians should not only be vigilant to the presence of ectopic or herniated pancreatic tissue, but also be mindful of the resulting complications.
Highlights
Pancreatic tissue found in the mediastinum is rare
Acute pancreatitis can be managed conservatively even if it is in the mediastinum
Unusual Locations for pancreatic tissue include stomach [2], duodenum [3], jejunum [4] and colon [5]. They are usually asymptomatic [6]. It is very rare for pancreatic tissue to be found in the mediastinum
Summary
Acute pancreatitis can be managed conservatively even if it is in the mediastinum. Ectopic or herniated pancreatic tissue is extremely rare and leads to unique clinical presentations, along with diagnostic and therapeutic. Clinicians should be vigilant to the presence of ectopic or herniated pancreatic tissue, and be mindful of the resulting complications. Authors’ contributions MBB found this case as very unique and after taking consent from patient, started literature review. MS wrote the manuscript and contributed to the literature review. MBB and MBB contributed to literature review and wrote the final abstract. Author details 1 Department of Internal Medicine, University of Missouri, Kansas City (UMKC), 2411 Holmes Street, Kansas City, MO 64108, USA. 2 Internal Medicine, Jamaica Hospital Medical Center, New York, USA. 5 Indiana University School of Medicine, Indianapolis, IN, USA
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