Pancreatic duct rupture associated with high-grade pancreatic intraepithelial neoplasia treated by radical resection: a case report

We here report a case of pancreatic duct rupture associated with high-grade pancreatic intraepithelial neoplasia treated by radical resection. A 71-year-old man presented to our hospital because of abdominal bloating. Diagnoses of early-stage pancreatic body cancer with pancreatic duct rupture, panc...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2022-06, Vol.15 (3), p.662-667
Main Authors: Shintakuya, Ryuta, Kohashi, Toshihiko, Honmyo, Naruhiko, Hihara, Jun, Kaneko, Mayumi, Yukutake, Masanobu, Sekito, Tsuyoshi, Mukaida, Hidenori
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Ascites
Case Report
Cholangiopancreatography, Endoscopic Retrograde
Colorectal Surgery
Gastroenterology
Hepatology
Humans
Inflammation - complications
Inflammation - pathology
Inflammation - surgery
Male
Medicine
Medicine & Public Health
Pancreatectomy
Pancreatic Ducts - diagnostic imaging
Pancreatic Ducts - pathology
Pancreatic Ducts - surgery
Pancreatic Neoplasms - complications
Pancreatic Neoplasms - diagnostic imaging
Pancreatic Neoplasms - surgery
Surgical Oncology
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Summary:We here report a case of pancreatic duct rupture associated with high-grade pancreatic intraepithelial neoplasia treated by radical resection. A 71-year-old man presented to our hospital because of abdominal bloating. Diagnoses of early-stage pancreatic body cancer with pancreatic duct rupture, pancreatic ascites, and formation of a pseudocyst were made on the basis of blood tests, multidetector dynamic computed tomography, endoscopic ultrasonography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography. After achieving control of the ascites by placement of a pancreatic duct stent and aspiration of the pseudocyst, distal pancreatectomy with D2 lymph node dissection was performed. Intraoperative cytologic examination of the ascites was negative. The pathological diagnosis was high-grade pancreatic intraepithelial neoplasia in the pancreatic body. The branched pancreatic duct was occluded and dilated by acute inflammation around the pancreatic neoplasm, the inflammation being in the region of the dilated branched pancreatic duct and having caused its rupture. To the best of our knowledge, this is the first published report of pancreatic duct rupture associated with high-grade pancreatic intraepithelial neoplasia.
ISSN:1865-7257
1865-7265
1865-7265
DOI:10.1007/s12328-021-01587-0