title: [A case of pancreatic intraductal papillary-mucinous carcinoma with penetration to the stomach and splenic abscess].
abstract: We report the case of an 80-year-old man given a diagnosis of pancreatic intraductal papillary-mucinous carcinoma (IPMC) and early gastric cancer. He refused surgery, therefore endoscopic mucosal resection (EMR) for gastric cancer and careful observation were performed. Penetration of the IPMC to the stomach was observed 3 months later. Ten months after the initial diagnosis, he was found to have a splenic abscess and was subsequently treated by antibiotics and percutaneous drainage, and a fistula between the IPMC and the splenic abscess was observed. We suppose IPMC penetration to the spleen and bacterial transmission from the stomach through the fistula caused the splenic abscess. While IPMC is recognized as a low-grade malignancy, some cases of invasive carcinoma with fistulation to adjacent organs have been reported. To the best of our knowledge, this is the first case of IPMC associated with splenic abscess due to pancreatosplenic fistula.
authors.affiliation: Department of Gastroenterology and Hepatology, Nara City Hospital.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kanemasa
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sumida
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Imamura
authors.forename: Naho
authors.initials: N
authors.lastname: Katoh
authors.forename: Shunji
authors.initials: S
authors.lastname: Tachibana
authors.forename: Shoji
authors.initials: S
authors.lastname: Mitsufuji
authors.forename: Keisho
authors.initials: K
authors.lastname: Kataoka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology*; D002288:Adenocarcinoma, Mucinous / Q000150:complications; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications*; D002291:Carcinoma, Papillary / Q000150:complications; D005402:Fistula / Q000150:complications; D006801:Humans; D008297:Male; D010185:Pancreatic Fistula / Q000150:complications; D010190:Pancreatic Neoplasms / Q000150:complications*; D012422:Rupture, Spontaneous; D013158:Splenic Diseases / Q000209:etiology*; D013275:Stomach Rupture / Q000209:etiology*