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Biliary Stenosis and Gastric Outlet Obstruction: Late Complications After Acute Pancreatitis With Pancreatic Duct Disruption.
Sugimoto, Motokazu; Sonntag, David P; Flint, Greggory S; Boyce, Cody J; Kirkham, John C; Harris, Tyler J; Carr, Sean M; Nelson, Brent D; Bell, Don A; Barton, Joshua G; Traverso, L William.
Afiliación
  • Sonntag DP; Department of Interventional Radiology.
  • Boyce CJ; Department of Diagnostic Radiology, St. Luke's Health System, Boise, ID.
  • Kirkham JC; Department of Diagnostic Radiology, St. Luke's Health System, Boise, ID.
  • Harris TJ; Department of Interventional Radiology.
  • Carr SM; Department of Interventional Radiology.
  • Nelson BD; Department of Interventional Radiology.
  • Bell DA; Department of Interventional Radiology.
Pancreas ; 47(6): 772-777, 2018 07.
Article en En | MEDLINE | ID: mdl-29771770
OBJECTIVES: Pancreatic duct disruption (PDD) after acute pancreatitis can cause pancreatic collections in the early phase and biliary stenosis (BS) or gastric outlet obstruction (GOO) in the late phase. We aimed to document those late complications after moderate or severe acute pancreatitis. METHODS: Between September 2010 and August 2014, 141 patients showed pancreatic collections on computed tomography. Percutaneous drainage was primarily performed for patients with signs or symptoms of uncontrolled pancreatic juice leakage. Pancreatic duct disruption was defined as persistent amylase-rich drain fluid or a pancreatic duct cut-off on imaging. Clinical course of the patients who developed BS or GOO was investigated. RESULTS: Among the 141 patients with collections, 33 patients showed PDD in the pancreatic head/neck area. Among them, 9 patients (27%) developed BS 65 days after onset and required stenting for 150 days, and 5 patients (15%) developed GOO 92 days after onset and required gastric decompression and jejunal tube feeding for 147 days (days shown in median). All 33 patients recovered successfully without requiring surgical intervention. CONCLUSIONS: Anatomic proximity of the bile duct or duodenum to the site of PDD and severe inflammation seemed to contribute to the late onset of BS or GOO. Conservative management successfully reversed these complications.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conductos Pancreáticos / Pancreatitis / Enfermedades de las Vías Biliares / Obstrucción de la Salida Gástrica Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pancreas Asunto de la revista: GASTROENTEROLOGIA Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conductos Pancreáticos / Pancreatitis / Enfermedades de las Vías Biliares / Obstrucción de la Salida Gástrica Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Pancreas Asunto de la revista: GASTROENTEROLOGIA Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos