title: [A case of intraductal papillary mucinous carcinoma found with acute obstructive suppurative pancreatic ductitis and liver abscess, and associated with a pancreatobiliary fistula].
abstract: We report a rare case of intraductal papillary mucinous carcinoma (IPMC) with acute obstructive suppurative pancreatic ductitis (AOSPD), liver abscess, and pancreatobiliary fistula formation. A man in his sixties was admitted to our hospital with a chief complain of high grade fever and anorexia. CT and MRI revealed a multilocular cystic lesion in the pancreatic head, fistula formation between the common bile duct and this cystic lesion, and multiple liver abscess. We performed endoscopic nasopancreatic drainage for the AOSPD, endoscopic biliary drainage for the biliary flow obstruction, and percutaneous transhepatic drainage for the liver abscess. Klebsiella pneumoniae was detected in the culture of pancreatic juice and liver abscess, but not in the bile and blood culture. These culture studies revealed that the liver abscess was caused by AOSPD. The patient underwent pancreaticoduodenectomy for the IPMC. The pathological diagnosis was IPMC.
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital. nishie-hirotada@tajimi-hospital.jp
authors.forename: Hirotada
authors.initials: H
authors.lastname: Nishie
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Okumura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Fukusada
authors.forename: Tadahisa
authors.initials: T
authors.lastname: Inoue
authors.forename: Kenta
authors.initials: K
authors.lastname: Kachi
authors.forename: Kaiki
authors.initials: K
authors.lastname: Anbe
authors.forename: Makoto
authors.initials: M
authors.lastname: Natsume
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishi
authors.forename: Norihiro
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizushima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sano
authors.forename: Masaki
authors.initials: M
authors.lastname: Kajikawa
authors.forename: Akio
authors.initials: A
authors.lastname: Harada
authors.forename: Itaru
authors.initials: I
authors.lastname: Naitoh
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hayashi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakazawa
mesh_terms: D000208:Acute Disease; D002288:Adenocarcinoma, Mucinous / Q000150:complications*; D001658:Biliary Fistula / Q000150:complications*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000150:complications*; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications*; D002291:Carcinoma, Papillary / Q000150:complications*; D003135:Common Bile Duct; D006801:Humans; D007249:Inflammation; D008100:Liver Abscess / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000150:complications; D010183:Pancreatic Ducts / Q000473:pathology*; D010185:Pancreatic Fistula / Q000150:complications*; D010190:Pancreatic Neoplasms / Q000150:complications*