BACKGROUND Pancreatic neuroendocrine neoplasms(pNENs)are rare,heterogeneous tumors accounting for 1%-2%of pancreatic tumors,with significant malignant potential.Intraductal papillary mucinous neoplasm of the bile duct...BACKGROUND Pancreatic neuroendocrine neoplasms(pNENs)are rare,heterogeneous tumors accounting for 1%-2%of pancreatic tumors,with significant malignant potential.Intraductal papillary mucinous neoplasm of the bile duct(IPMN-B)is a rare precancerous lesion in the bile duct system,with potential for malignancy.The combination of pNENs and IPMN-B is exceptionally rare and often leads to misdiagnosis.This study aims to report a rare case of pNENs combined with IPMN-B treated at Yanbian University Hospital to improve understanding and management of this unusual tumor combination.CASE SUMMARY We retrospectively analyzed a case from Yanbian University Hospital.We re-viewed clinical records,imaging findings,endoscopic retrograde cholangiopan-creatography,surgical exploration,and histopathological examination.The pa-tient was diagnosed with pNENs and IPMN-B.Surgical treatment was performed,with follow-up showing effective management and no significant recurrence.CONCLUSION This case represents the first report of pNENs combined with IPMN-B.It high-lights the need for thorough diagnostic evaluation to prevent misdiagnosis and improve treatment strategies.展开更多
BACKGROUND Median arcuate ligament syndrome(MALS)is relatively rare and is due to extraluminal compression of the coeliac artery by the median arcuate ligament of the diaphragm.Here,we report a case of MALS found in a...BACKGROUND Median arcuate ligament syndrome(MALS)is relatively rare and is due to extraluminal compression of the coeliac artery by the median arcuate ligament of the diaphragm.Here,we report a case of MALS found in a patient with abdominal pain and retroperitoneal haemorrhage for education and dissemination.CASE SUMMARY This article describes a 46-year-old female patient who was admitted to our hospital with abdominal pain as her chief complaint.She had experienced no obvious symptoms but had retroperitoneal bleeding during the course of the disease.Contrast-enhanced computed tomography(CT)and noninvasive CT angiography(CTA)led to an initial misdiagnosis of pancreaticoduodenal artery aneurysm(PDAA)causing retroperitoneal hemorrhage.After intraoperative exploration and detailed analysis of enhanced CT and CTA images,a final diagnosis of MALS was made.The cause of the haemorrhage was bleeding from a branch of the gastroduodenal artery,not rupture of a PDAA.The prognosis of MALS combined with PDAA treated by laparoscopy and interventional therapy is still acceptable.The patient was temporarily treated by gastroduodenal suture haemostasis and was referred for further treatment.CONCLUSION MALS is very rare and usually has postprandial abdominal pain,upper abdominal murmur,and weight loss.It is diagnosed by imaging or due to complications.When a patient has abdominal bleeding or PDAA,we should consider whether the patient has celiac trunk stenosis(MALS or other etiology).When abdominal bleeding is combined with an aneurysm,we generally think of aneurysm rupture and hemorrhage first,but it may also be collateral artery rupture and hemorrhage.展开更多
文摘BACKGROUND Pancreatic neuroendocrine neoplasms(pNENs)are rare,heterogeneous tumors accounting for 1%-2%of pancreatic tumors,with significant malignant potential.Intraductal papillary mucinous neoplasm of the bile duct(IPMN-B)is a rare precancerous lesion in the bile duct system,with potential for malignancy.The combination of pNENs and IPMN-B is exceptionally rare and often leads to misdiagnosis.This study aims to report a rare case of pNENs combined with IPMN-B treated at Yanbian University Hospital to improve understanding and management of this unusual tumor combination.CASE SUMMARY We retrospectively analyzed a case from Yanbian University Hospital.We re-viewed clinical records,imaging findings,endoscopic retrograde cholangiopan-creatography,surgical exploration,and histopathological examination.The pa-tient was diagnosed with pNENs and IPMN-B.Surgical treatment was performed,with follow-up showing effective management and no significant recurrence.CONCLUSION This case represents the first report of pNENs combined with IPMN-B.It high-lights the need for thorough diagnostic evaluation to prevent misdiagnosis and improve treatment strategies.
文摘BACKGROUND Median arcuate ligament syndrome(MALS)is relatively rare and is due to extraluminal compression of the coeliac artery by the median arcuate ligament of the diaphragm.Here,we report a case of MALS found in a patient with abdominal pain and retroperitoneal haemorrhage for education and dissemination.CASE SUMMARY This article describes a 46-year-old female patient who was admitted to our hospital with abdominal pain as her chief complaint.She had experienced no obvious symptoms but had retroperitoneal bleeding during the course of the disease.Contrast-enhanced computed tomography(CT)and noninvasive CT angiography(CTA)led to an initial misdiagnosis of pancreaticoduodenal artery aneurysm(PDAA)causing retroperitoneal hemorrhage.After intraoperative exploration and detailed analysis of enhanced CT and CTA images,a final diagnosis of MALS was made.The cause of the haemorrhage was bleeding from a branch of the gastroduodenal artery,not rupture of a PDAA.The prognosis of MALS combined with PDAA treated by laparoscopy and interventional therapy is still acceptable.The patient was temporarily treated by gastroduodenal suture haemostasis and was referred for further treatment.CONCLUSION MALS is very rare and usually has postprandial abdominal pain,upper abdominal murmur,and weight loss.It is diagnosed by imaging or due to complications.When a patient has abdominal bleeding or PDAA,we should consider whether the patient has celiac trunk stenosis(MALS or other etiology).When abdominal bleeding is combined with an aneurysm,we generally think of aneurysm rupture and hemorrhage first,but it may also be collateral artery rupture and hemorrhage.
