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Case Report
Infected hemorrhagic pancreatic pseudocyst: A rare complication of acute pancreatitis
1 General Practitioner, Department of Internal Medicine, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
2 Internist, Department of Internal Medicine, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
3 Digestive Surgeon, Department of Surgery, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
Address correspondence to:
Dian Daniella
Jalan Bisma 6 blok B 12 nomor 17, Jakarta Utara, DKI Jakarta,
Indonesia
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Article ID: 100009G01DD2019
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How to cite this article
Daniella D, Wiguna C, Jeo WS. Infected hemorrhagic pancreatic pseudocyst: A rare complication of acute pancreatitis. Edorium J Gastroenterol 2019;6:100009G01DD2019.ABSTRACT
Introduction: Pancreatitis is an uncommon disease defined as an inflammatory disorder of the pancreas that can be acute or chronic. After four weeks, unresolved acute pancreatitis can result in pancreatic pseudocyst. Usually pancreatic pseudocyst formed in the absence of pancreatic necrosis, although rare but exception has been reported and it affects the treatment of choice. Pseudocyst must be managed correctly due to its high mortality complication, such as bleeding pseudoaneurysm.
Case Report: A 51-year-old man presented to the emergency room with his third episode of abdominal pain. In one month prior, the patient had already been hospitalized twice with acute pancreatitis. He came with severe abdominal pain three hours prior to admission. Patient had a history of alcohol abuse. Physical examination revealed tachycardia, afebrile, distended, and rigid abdomen with no bowel sound. Laboratory examination revealed high leucocyte (35,200/uL), high amylase (1063 U/L), and high lipase (540 U/L). Abdominal computed tomography (CT) scan revealed enlargement of pancreas body and tail with heterogenous density (necrotic), with around 11 cm mass containing fluid mean 70 HU (blood) in pancreas body. One week before the abdominal CT scan showed acute pancreatitis with no cyst. The patient was kept fasting with parenteral nutrition, antibiotic, octreotide subcutaneously, opioid, and laparoscopic drainage and debridement was scheduled. During surgery, mass containing approximately 1000 mL of fluid and blood clot was seen and drained. The patient did well after the surgery.
Conclusion: Diagnosis and prompt treatment of pseudocyst is important. In a patient with pseudocyst and necrotizing pancreatitis, surgical drainage is the treatment of choice.
Keywords: Hemorrhagic, Laparoscopic drainage, Pancreatitis, Pseudocyst
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Author Contributions
Dian Daniella - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Candra Wiguna - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
WIfanto Saditya Jeo - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Dian Daniella et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
