Spontaneous Rupture of Pancreatic Pseudocyst: Report of Two Cases.

Ricardo Rocha,Vitor Nunes,Nuno Pignatelli,Carla Carneiro,Rui Marinho,Marta Sousa,António Gomes

doi:10.1155/2016/7056567

Abstract

Introduction. Pancreatic pseudocysts are a common complication of acute pancreatitis. Pancreatic pseudocyst's natural history ranges between its spontaneous regression and the settlement of serious complications if untreated, such as splenic complications, hemorrhage, infection, biliary complications, portal hypertension, and rupture. The rupture of a pancreatic pseudocyst to the peritoneal cavity is a dangerous complication leading to severe peritonitis and septic conditions. It requires emergent surgical exploration that is often of great technical difficulty and with important morbidity and mortality. Case Study. We present two cases of spontaneous rupture of pancreatic pseudocysts, managed differently according to the local and systemic conditions. Conclusion. The best surgical choice is the internal drainage of the cyst to the GI tract; however, in some conditions, the external drainage is the only choice available.

Highlights

Pancreatic pseudocysts are a common complication of acute pancreatitis
Pancreatic pseudocysts are caused by pancreatic ductal disruption following increased pancreatic ductal pressure, either due to stenosis, calculi, or protein plugs obstructing the main pancreatic ductal system or as a result of pancreatic necrosis following an attack of acute pancreatitis [3]
We introduced total parenteral nutrition, to avoid food intake, and suppressors of pancreatic secretion during 2 weeks

Summary

Introduction

Pancreatic pseudocysts are a common clinical problem after acute pancreatitis, with an estimated prevalence of 6 to 18.5%. Pseudocyst of the pancreas is an encapsulated collection of fluid with a well-defined inflammatory wall usually outside the pancreas with minimal or no necrosis, usually occurring more than 4 weeks after onset on acute pancreatitis [2]. Its clinical presentation may range from a completely asymptomatic patient to the onset of serious complications. The vast majority is treated electively; the incidence of complications needing emergent surgical management is not despicable [3]. Spontaneous rupture of pancreatic pseudocysts is a serious complication leading to severe peritonitis and the need of emergent surgical exploration

Case Reports

Findings

Discussion