Gastric necrosis and perforation as a severe complication of pancreatic pseudocyst.
Patients with acute pancreatitis may present with stress-related gastrointestinal mucosal lesions. But severe gastrointestinal complications such as gastric perforation are very rare. Here, we report a 40-year-old man who was admitted due to acute pancreatitis and pseudocyst formation. During hospitalization, panendoscopic examination found multiple scattered stress ulcers over the gastric antrum and a large ulcerative area with suspicious malignant features at the body and fundus. The patient received surgical intervention due to worsening of his clinical condition. Postoperative findings showed a perforation of the gastric wall at the region in contact with the pseudocyst, and microscopic examination found diffuse ischemia and necrosis with intravascular thrombus and emboli in gastric vessels. We suggest keeping in mind that pancreatic pseudocyst may cause serious gastrointestinal complications including massive necrosis and perforation of the gastric wall.
Hsu
Chia-Yang
CY
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
Lee
Kuei-Chuan
KC
Chan
Che-Chang
CC
Lee
Fa-Yauh
FY
Lin
Han-Chieh
HC
D000208:Acute Disease; D000328:Adult; D005753:Gastric Mucosa / Q000098:blood supply / Q000293:injuries* / Q000473:pathology*; D006801:Humans; D007511:Ischemia / Q000150:complications; D008297:Male; D009336:Necrosis; D010192:Pancreatic Pseudocyst / Q000150:complications*; D010195:Pancreatitis / Q000150:complications