PANCREATODUODENECTOMY DUE TO LIPOMATOUS PSEUDOHYPERTROPHY OF THE PANCREAS.
Journal
Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery
ISSN: 2317-6326
Titre abrégé: Arq Bras Cir Dig
Pays: Brazil
ID NLM: 9100283
Informations de publication
Date de publication:
2023
2023
Historique:
received:
10
05
2023
accepted:
05
06
2023
medline:
22
9
2023
pubmed:
20
9
2023
entrez:
20
9
2023
Statut:
epublish
Résumé
Lipomatous pseudohypertrophy of the pancreas, pancreatic lipomatosis, pancreatic steatosis, non-alcoholic fatty pancreatic disease, or fatty pancreas is an extremely rare disease, characterized by the organ enlargement and a localized or diffuse replacement of pancreatic acinar cells by mature adipose tissue, preserving the pancreatic ductal system and islets of Langerhans. To report a rare case of lipomatous pseudohypertrophy of the pancreas in a symptomatic patient and the surgical treatment employed. A 24-year-old male patient with weight loss (10 kilograms in 8 months), hyperglycemia, severe and recurrent acute abdominal pain, epigastric discomfort associated with nausea, vomiting, and jaundice for 40 days. Magnetic resonance imaging was performed, revealing an irregular lipomatous pseudohypertrophy of the pancreas, measuring 6.0 × 5.6 cm in the head, uncinate process, and part of the body of the pancreas. The pancreatic duct dilation was diffuse and irregular, associated with atrophy of the remnant parenchyma, particularly in the tail of the pancreas. The patient underwent pancreatoduodenectomy without total mesopancreas excision followed by pancreatojejunostomy. The postoperative course was uneventful, the length of stay in the ICU was two days, and the patient was discharged on the seventh postoperative day. The disease treatment depends on the signs and symptoms at presentation and a pancreatoduodenectomy is indicated in patients with severe and recurrent abdominal pain.
Sections du résumé
BACKGROUND
BACKGROUND
Lipomatous pseudohypertrophy of the pancreas, pancreatic lipomatosis, pancreatic steatosis, non-alcoholic fatty pancreatic disease, or fatty pancreas is an extremely rare disease, characterized by the organ enlargement and a localized or diffuse replacement of pancreatic acinar cells by mature adipose tissue, preserving the pancreatic ductal system and islets of Langerhans.
AIMS
OBJECTIVE
To report a rare case of lipomatous pseudohypertrophy of the pancreas in a symptomatic patient and the surgical treatment employed.
METHODS
METHODS
A 24-year-old male patient with weight loss (10 kilograms in 8 months), hyperglycemia, severe and recurrent acute abdominal pain, epigastric discomfort associated with nausea, vomiting, and jaundice for 40 days. Magnetic resonance imaging was performed, revealing an irregular lipomatous pseudohypertrophy of the pancreas, measuring 6.0 × 5.6 cm in the head, uncinate process, and part of the body of the pancreas. The pancreatic duct dilation was diffuse and irregular, associated with atrophy of the remnant parenchyma, particularly in the tail of the pancreas. The patient underwent pancreatoduodenectomy without total mesopancreas excision followed by pancreatojejunostomy.
RESULTS
RESULTS
The postoperative course was uneventful, the length of stay in the ICU was two days, and the patient was discharged on the seventh postoperative day.
CONCLUSIONS
CONCLUSIONS
The disease treatment depends on the signs and symptoms at presentation and a pancreatoduodenectomy is indicated in patients with severe and recurrent abdominal pain.
Identifiants
pubmed: 37729275
pii: S0102-67202023000100400
doi: 10.1590/0102-672020230036e1754
pmc: PMC10510371
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1754Références
Postgrad Med J. 1974 Jan;50(579):53-5
pubmed: 4464502
Turk J Surg. 2020 Sep 28;36(3):241-248
pubmed: 33778378
JOP. 2010 Jul 05;11(4):385-8
pubmed: 20601816
Arq Bras Cir Dig. 2022 Jun 17;35:e1643
pubmed: 35730872
Arq Bras Cir Dig. 2017 Oct-Dec;30(4):260-263
pubmed: 29340550
Radiol Case Rep. 2021 Apr 09;16(6):1363-1367
pubmed: 33897930
Case Rep Gastroenterol. 2010 Oct 22;4(3):457-464
pubmed: 21103205
Pancreas. 2010 Apr;39(3):392-7
pubmed: 19904221
Eurasian J Med. 2010 Apr;42(1):24-7
pubmed: 25610114
PLoS One. 2018 Dec 20;13(12):e0209448
pubmed: 30571730
Eur J Case Rep Intern Med. 2021 May 18;8(5):002556
pubmed: 34123944
World J Diabetes. 2014 Aug 15;5(4):415-9
pubmed: 25126389
J Belg Soc Radiol. 2016 Feb 23;100(1):39
pubmed: 30151451