Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinos...Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinoscrotal swelling.They were initially misdiagnosed with obstructed inguinal hernia,epididymo-orchitis and hydrocele,respectively.Later,their diagnosis of acute pancreatitis was revealed on laparotomy in one patient and on computed tomography(CT)in the remaining two patients.All these cases had extensive peripancreatic necrosis and paracolic collections tracking along the psoas muscle,downwards towards the pelvis.These collections were initially managed by percutaneous drainage and saline irrigation as a part of the‘step-up’approach.Two of these patients required open necrosectomy,while all required incision and drainage of inguinoscrotal collections.All the patients were discharged in satisfactory condition.Inguinoscrotal swelling is unusual as a first presentation of acute pancreatitis.A high index of suspicion,with careful study of patient’s history and examination along with CT,may provide an accurate diagnosis.Local drainage may be required to control sepsis and also provide an egress route for intra-abdominal collections.展开更多
Simultaneous dilation of both the common bile duct and the pancreatic duct(double-duct sign)is usually because of ampullary or pancreatic tumours.Here we report an unusual cause of double-duct dilation;we describe the...Simultaneous dilation of both the common bile duct and the pancreatic duct(double-duct sign)is usually because of ampullary or pancreatic tumours.Here we report an unusual cause of double-duct dilation;we describe the case of a 49-year-old female who developed afferent loop syndrome after pylorus-preserving pancreaticoduodenectomy:crosssectional imaging of the abdomen revealed a double-duct sign.展开更多
文摘Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinoscrotal swelling.They were initially misdiagnosed with obstructed inguinal hernia,epididymo-orchitis and hydrocele,respectively.Later,their diagnosis of acute pancreatitis was revealed on laparotomy in one patient and on computed tomography(CT)in the remaining two patients.All these cases had extensive peripancreatic necrosis and paracolic collections tracking along the psoas muscle,downwards towards the pelvis.These collections were initially managed by percutaneous drainage and saline irrigation as a part of the‘step-up’approach.Two of these patients required open necrosectomy,while all required incision and drainage of inguinoscrotal collections.All the patients were discharged in satisfactory condition.Inguinoscrotal swelling is unusual as a first presentation of acute pancreatitis.A high index of suspicion,with careful study of patient’s history and examination along with CT,may provide an accurate diagnosis.Local drainage may be required to control sepsis and also provide an egress route for intra-abdominal collections.
文摘Simultaneous dilation of both the common bile duct and the pancreatic duct(double-duct sign)is usually because of ampullary or pancreatic tumours.Here we report an unusual cause of double-duct dilation;we describe the case of a 49-year-old female who developed afferent loop syndrome after pylorus-preserving pancreaticoduodenectomy:crosssectional imaging of the abdomen revealed a double-duct sign.
