Clinical presentation of mucin-secreting tumors of the pancreas.
BACKGROUND
Pancreatitis and jaundice secondary to ductal obstruction are common in intraductal papillary mucinous tumors (IPMT) of the pancreas. However, the incidence and severity of the complications of obstruction are not well documented. The aim of the study was to investigate the clinical presentation and outcome of 10 patients with IPMT.


METHODS
All cases of IPMT diagnosed between 1994 and 1999 were reviewed.


RESULTS
Four of the 10 patients developed severe acute illness with systemic complications resulting from ductal obstruction. Three suffered acute cholangitis with sepsis, and 1 developed necrotizing pancreatitis and ARDS. There was 1 postoperative death in a patient with adenocarcinoma. All other patients are alive and well with a median follow-up of 26 months (survival 90%).


CONCLUSIONS
Pancreatic or common bile duct obstruction in IPMT may result in acute, life-threatening disease. Aggressive surgical therapy is warranted before development of complications of ductal obstruction or progression of tumor occurs.
Department of Surgery, Stanford University Medical School, Stanford, California 94305-5101, USA.
F
F
Tibayan
M
M
Vierra
B
B
Mindelzun
D
D
Tsang
J
J
McClenathan
H
H
Young
H W
HW
Trueblood
D000208:Acute Disease; D002288:Adenocarcinoma, Mucinous / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000209:etiology; D002779:Cholestasis / Q000209:etiology; D018291:Cystadenoma, Mucinous / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010195:Pancreatitis / Q000209:etiology; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome