title: Untractable diarrhea due to late onset celiac disease of the adult following pancreatoduodenectomy.
abstract: This case describes a rare cause of severe diarrhea that may occasionally plague the postoperative course of pancreatic resections. Although exceedingly rare this complication has already been described in another two patients undergoing pancreatoduodenectomy with diagnosis of duodenojejunal adenocarcinoma. Surgeons dedicated to pancreatic resections as well as pancreatologists caring for these patients should retain this possibility in their cultural background. Diarrhea, due to either exocrine insufficiency or interruption of sympathetic nerves to the small intestine, is a common complaint after pancreatoduodenectomy. A 54-year-old white female after a pancreatoduodenectomy with standard lymphatic clearance developed intractable diarrhea leading to severe cachexia. Recognition of the underlying occult celiac disease and institution of the appropriate dietary regimen allowed quick and expeditious recovery.
authors.affiliation: Division of General Surgery and Transplants, Department of Oncology, Transplants and New Technologies in Medicine, University of Pisa, 56124 Pisa, Italy. u.boggi@patchir.med.unipi.it
authors.forename: U
authors.initials: U
authors.lastname: Boggi
authors.forename: R
authors.initials: R
authors.lastname: Bellini
authors.forename: E
authors.initials: E
authors.lastname: Rossetti
authors.forename: A
authors.initials: A
authors.lastname: Pietrabissa
authors.forename: F
authors.initials: F
authors.lastname: Mosca
mesh_terms: D000208:Acute Disease; D002446:Celiac Disease / Q000209:etiology*; D003967:Diarrhea / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D013997:Time Factors