Ces radiol. 2019, 73(4):263-266 | DOI: 10.55095/CesRadiol2019/040

Pancreatic adenocarcinoma in a case of post-traumatic pancreatitis with pancreatic duct disruptionCase report

Robert Psár^1,2,3, Lukáš Bača⁴, Veronika Psárová⁴, Marie Černá^3,5, Jaroslav Krátký¹

¹ Radiologické oddělení, Vítkovická nemocnice a.s., Ostrava-Vítkovice

² Vzdělávací a výzkumný institut AGEL o. p. s., Prostějov

³ Lékařská fakulta, Univerzita Palackého, Olomouc

⁴ Centrum péče o zažívací trakt, Vítkovická nemocnice, Ostrava-Vítkovice

⁵ Radiologická klinika LF UP a FN, Olomouc

We present a case report of a 61 years old male monitored for post-traumatic acute pancreatitis, with pancreatic duct disruption and subsequent pseudocyst formation in the pancreatic tail. Because of gradual progression of this pseudocyst's size, the patient was indicated for endoscopic ultrasound-guided pseudocystogastrostomy with 3 double pig-tail stents. In the meantime, the patient's condition was complicated by an infection of the pseudocyst, which was managed using antibiotic therapy. During the next year, the patient had to be repeatedly admitted at the gastroenterology department for pancreatic duct drainage using ERCP (5×). During this time, a pancreatic stent was introduced and repeatedly had to be replaced. Repeated check-ups were performed using abdominal ultrasound and CT (computed tomography - 6×) and endosonography of the pancreas, including fine-needle aspiration (EUS-FNA - 2×). Less than two years after the injury, multiple liver metastases were found using CT, the primary tumour was not detected. In a follow-up endosonography, a hypoechogenic mass was found in the pancreatic body, with evidence of malignant cells according to the collected cytology. After the final diagnosis of pancreatic adenocarcinoma, the patient has died, with cause of death being the spreading of the disease.

Keywords: pancreatic duct disruption, pancreatic ductal adenocarcinoma, endoscopic pseudocystogastrostomy, endosonography, postraumatic pancreatitis, fine-needle aspiration

Grants and funding:

Podpořeno grantem IGA UP číslo IGA_ LF_2019_002.

Accepted: November 15, 2019; Published: December 1, 2019  Show citation