1
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Abdominal Pain After Subtotal Gastrectomy: A First Report of Accessory Pancreatic Fistula

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          The accessory pancreatic duct (APD) is the main drainage duct of the dorsal pancreatic bud in the embryo and varies greatly during development. An APD fistula is a rare and easily neglected complication. In this case report, the first symptom of the patient was postoperative abdominal pain and fever. He was eventually diagnosed with accessory pancreatic fistula combined with duodenal fistula. Such a case has not been reported in the literature.

          Case Summary

          A 66-year-old man was emergently hospitalized for abdominal pain. His preliminary diagnosis was perforation of the digestive tract. He developed fever and abdominal pain after emergency subtotal gastrectomy, followed by changes in the colour of the abdominal drainage fluid. An APD fistula and duodenal stump fistula were confirmed by drainage fluid amylase analysis, contrast fistulography and percutaneous transhepatic cholangial drainage (PTCD). After PTCD, nutritional management and drug treatment, the patient recovered well.

          Outcome

          We found and successfully cured a case of accessory pancreatic duct fistula combined with duodenal stump fistula.

          Related collections

          Most cited references 10

          • Record: found
          • Abstract: found
          • Article: not found

          Pneumoperitoneum and its association with ruptured abdominal viscus.

          Pneumoperitoneum is not invariably associated with ruptured or perforated intra-abdominal viscus. To determine the incidence of free air associated with intra-abdominal viscus perforation, the medical records of 77 consecutive patients whose discharge or autopsy diagnosis included pneumoperitoneum or perforated viscus at a community hospital were retrospectively reviewed between June 1980 and October 1985. Abdominal viscus perforation, as determined by contrast studies or at operation, was not invariably associated with free air. Sixty-nine percent (23/33) of gastroduodenal, 30% (3/10) of small-bowel, and 37% (11/30) of large-bowel perforations had free air, as determined by preoperative x-ray film. Four cases with a total of six episodes of pneumoperitoneum were identified where viscus perforation was not documented. Pneumoperitoneum thus remains a reliable sign of viscus perforation; however, lack of this finding does not rule out perforation, and unusual causes must be considered.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Management of duodenal stump fistula after gastrectomy for gastric cancer: Systematic review.

            To identify the most effective treatment of duodenal stump fistula (DSF) after gastrectomy for gastric cancer.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Enteral and parenteral nutrition in the conservative treatment of pancreatic fistula: a randomized clinical trial.

              Postoperative pancreatic fistula is the most common and potentially life-threatening complication after pancreatic surgery. Although nutritional support is a key component of conservative therapy in such cases, there have been no well-designed clinical trials substantiating the superiority of either total parenteral nutrition or enteral nutrition. This study was conducted to compare the efficacy and safety of both routes of nutritional intervention. A randomized clinical trial was conducted in a tertiary surgical center of pancreatic and gastrointestinal surgery. Seventy-eight patients with postoperative pancreatic fistula were treated conservatively and randomly assigned to groups receiving for 30 days either enteral nutrition or total parenteral nutrition. The primary end point was the 30-day fistula closure rate. After 30 days, closure rates in patients receiving enteral and parenteral nutrition were 60% (24 of 40) and 37% (14 of 38), respectively (P=.043). The odds ratio for the probability that fistula closes on enteral nutrition compared to total parenteral nutrition was 2.571 (95% confidence interval [CI]: 1.031-6.411). Median time to closure was 27 days (95% CI: 21-33) for enteral nutrition, and no median time was reached in total parenteral nutrition (P=.047). A logistic regression analysis identified only 2 factors significantly associated with fistula closure, ie, enteral nutrition (odds ratio=6.136; 95% CI: 1.204-41.623; P=.043) and initial fistula output of ≤200 mL/day (odds ratio=12.701; 95% CI: 9.102-47.241; P<.001). Enteral nutrition is associated with significantly higher closure rates and shorter time to closure of postoperative pancreatic fistula. Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.
                Bookmark

                Author and article information

                Journal
                J Pain Res
                J Pain Res
                JPR
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                19 February 2020
                2020
                : 13
                : 431-435
                Affiliations
                [1 ]Graduate School of Peking Union Medical College , Beijing 100029, People’s Republic of China
                [2 ]Department of General Surgery, China-Japan Friendship Hospital , Beijing 100029, People’s Republic of China
                Author notes
                Correspondence: Zhi-Ying Yang Department of General Surgery, China-Japan Friendship Hospital , 2 Cherry Blossom East Street, Beijing100029, People’s Republic of China Email yangzhy@aliyun.com
                Article
                238599
                10.2147/JPR.S238599
                7037110
                © 2020 Zhang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 2, References: 12, Pages: 5
                Categories
                Case Report

                Comments

                Comment on this article