Spontaneous Internal Drainage of Pancreatic Pseudocysts

Case Details

Personal Characteristics

28-year-old black alcoholic, b. W., had had several previous chemically documented attacks of acute pancreatitis

Clinical Characteristics

Severe epigastric pain with radiation to the back, a sense of abdominal fullness, nausea, vomiting, and anorexia. Epigastric tenderness and decreased bowel sounds. Glycosuria, hyperglycemia, and marked hyperamylasemia. Epigastric pain recurred, serum amylase values rose, and a large epigastric mass became palpable. Developed mild hematemesis

Remission Characteristics

Initially the symptoms remitted and serum amylase values fell, but after a few relatively symptom-free days, the epigastric pain recurred, serum amylase values rose, and a large epigastric mass became palpable. During the next 2 days the epigastric mass disappeared, and 3 days after the barium study a repeat ultrasonic examination confirmed complete resolution of the mass

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

An ultrasonic abdominal examination, upper gastrointestinal barium examination

Additional Notes

Spontaneous internal drainage between a pancreatic pseudocyst and the alimentary tract became established. The communication was demonstrated radiologically