Intestinal Obstruction by a Pancreatic Bezoar: A Case Report
Context Pancreatic pseudocysts are relatively common complications of pancreatitis. A pseudocyst can result from an episode of acute pancreatitis, exacerbation of chronic pancreatitis, or trauma. Treatment is indicated for persistent, symptomatic pseudocysts and in the case of related complications. Case report We describe the case of a 66-year-old man who referred to our department for bowel obstruction caused by a necrotic pancreatic bezoar occurring 16 days after the patient underwent a jejunal-pseudocyst anastomosis performed to treat a post-pancreatitis voluminous pseudocyst obstructing the gastric outlet. Conclusion In case of intestinal obstruction after a jejunal-pseudocyst anastomosis, pancreatic bezoar should be considered in the armamentarium of the differential diagnosis.
Image: Bezoar removed through an enterotomy.
Habashi S, Draganov P. Pancreatic pseudocyst. World J Gastroenterol. 2009; 15: 38-47. [PMCID:PMC2653285]
Behrns KE, Ben David K. Surgical Therapy of Pancreatic Pseudocysts. J Gastrointest Surg. 2008; 12: 2231-2239. [PMID:18461418]
Ungania S, Panocchia N. Splenic artery rupture in pancreatic pseudocyst. Ann Ital Chir 2000; 71: 251-255. [PMID:10920499]
Cannon JW, Callery MP, Vollmer CM Jr. Diagnosis and Management of Pancreatic Pseudocysts: What is the Evidence. J Am Coll Surg. 2009; 209: 385-393. [PMID:19717045]
Seicean A, Stan-Iuga R, Badea R, Tantau M, Mocan T, Seicean R, Iancu C, et al. The Safety of Endoscopic. Ultrasonography Guided Drainage of Pancreatic Fluid Collections Without Fuloroscopic Control: a Single tertiary Center Experience. J Gastrointestin Liver Dis. 2011; 39-45. [PMID:21451796]
Sadik R, Kalaitzakis E, Thune A, Hansen J, Jonson C. EUS guided drainage is more successful in pancreatic pseudocyst compared with abscesses. World J Gastroenterol. 2001; 17: 499-505. [PMID:21274380]
Dohmoto M, Rupp KD. Endoscopic management of pancreatic pseudocysts. Diagn Ther Endosc. 1994; 1: 29-35. [PMID:18493338]
Ito K, Perez A, Ito H, Whang EE. Pancreatic pseudocyst: is delayed surgical intervention associated with adverse outcomes? J Gastrointest Surg. 2007; 11: 1317-1321. [PMID:17674114]
Shapiro PD, Babbin G, Matolo NM. Phytobezoar and obstruction of the small intestine following gastrectomy. West J Med 1976; 124: 506-508. [PMID:936604]
Rogers L, Davis E, Harle T. Phytobezoar formation and food boli following gastric surgery. Am J Roentgenol Radium Ther Nucl Med 1973; 119: 280-290. [PMID:4748215]
Wapnick S, Solowiejczyk M. Bezoar formation after vagotomy and pyloroplasty. Int Surg 1974; 59: 241-242. [PMID:4831430]
Tayeb M, Khan FM, Raul F, Khan MM. Phytobezoar in a jejunal diverticulum as a cause of small bowel obstruction: a case report. J Med Case Rep. 2011; 5: 482. [PMID:21951579]
Katras T, Stein M. Mechanical intestinal obstruction from pseudocyst bezoar following internal drainage of traumatic pancreatic pseudocyst. J Trauma. 1988; 28: 1406-7. [PMID:3418772]
Copyright (c) 2014 Margherita Luperto, Matteo Maternini, Arianna Ciravegna, Luca Degrate, Giulia Lo Bianco, Stefano Zanella, Fabrizio Romano, Luca Gianotti
This work is licensed under a Creative Commons Attribution 4.0 International License.As a member of Publisher International Linking Association, PILA, iMedPub Group’s JOP follows the Creative Commons Attribution License and Scholars Open Access publishing policies. Journal of the Pancreas is the Council Contributor Member of Council of Science Editors (CSE) and following the CSE slogan Education, Ethics, and Evidence for Editors.