Journal of Yeungnam Medical Science

Case Reports

Mediastinal pancreatic pseudocyst naturally drained by esophageal fistula: Soo Ho Park, Seung Keun Park, Sang Hyun Kim, Won Kyu Choi, Beom Jin Shim, Hee Ug Park, Chan Woo Jung, Jae Won Choi; Yeungnam Univ J Med. 2017;34(2):254-259. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.254

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Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis. Pleural effusion and pneumonia are two of the most common thoracic complications from pancreatic disease, while pancreaticopleural fistula with massive pleural effusion and extension of pseudocyst into the mediastinum is a rare complication of the thorax from pancreatic disease. To the best of our knowledge, there have been no case reports of mediastinal pancreatic pseudocyst-induced esophageal fistula in Korea to date. Here in, we report a case about 43-year-old man of mediastinal pancreatic pseudocyst-induced esophageal fistula presenting with chest pain radiating toward the back and progressive dysphagia. The diagnosis was confirmed by an esophagogastroduodenoscopy and abdomen computed tomography (CT). The patient was treated immediately using a conservative method; subsequently, within 3 days from treatment initiation, symptoms-chest pain and dysphagia-disappeared. In a follow-up gastroscopy 7 days later and abdomen CT 12 days later, mediastinal pancreatic pseudocyst showed signs of improvement, and esophageal fistula disappeared without any complications.

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Pseudocyst of the pancreas masquerading as spontaneous pneumomediastinum
John D L Brookes, Manish Mathew, Charlene P Munasinghe, John C Gribbin, David A Devonshire, Prashant Joshi, Andrew D Cochrane
Journal of Surgical Case Reports.2019;[Epub] CrossRef

Metformin induced acute pancreatitis and lactic acidosis in a patient on hemodialysis.: Yeon Kyung Lee, Kihyun Lim, Su Hyun Hwang, Young Hwan Ahn, Gyu Tae Shin, Heungsoo Kim, In Whee Park; Yeungnam Univ J Med. 2016;33(1):33-36. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.33

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Abstract PDF

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

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Sex-differences in [68Ga]Ga-DOTANOC biodistribution
A. Leisser, K. Lukic, M. Nejabat, W. Wadsak, M. Mitterhauser, M. Mayerhöfer, G. Karnaikas, M. Raderer, M. Hacker, A.R. Haug
Nuclear Medicine and Biology.2019; 76-77: 15. CrossRef

A Case of Parathyroid Adenoma Presenting as Acute Pancreatitis Accompanied with Empty Sella.: Eon Ju Jun, Ji He O, Kyung Ryun Bae, Saet Byul Jang, Seung Woon Jun, Eui Dal Jung, Ho Sang Shon, Kyu Chang Won; Yeungnam Univ J Med. 2009;26(1):63-69. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.63

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Abstract PDF: The incidence of coexisting hyperparathyroidism and empty sella syndrome is rare and the etiology and incidence of their coexistence is not known. The association of hyperparathyroidism and the empty sella syndrome may be related to multiple endocrine neoplasia (MEN) syndrome due to a genetic disorder. We experienced a rare case of hyperparathyroidism presenting as acute pancreatitis combined with empty sella. We report here a 37-year old female who manifested epigastric pain because of acute pancreatitis. She had hypercalcemia due to parathyroid adenoma. A pituitary gland was not visible in the sella turcica on MRI scans. On genetic analysis, she did not show a mutation of the MENIN gene. Empty sella is thought to be a coincidental finding with hyperparathyroidism.

Normal Amylase and Lipase Serum Level in Acute Pancreatitis : A Case Report: Kwang Hae Choi; Yeungnam Univ J Med. 2007;24(2 Suppl):S627-631. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S627

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Abstract PDF: Acute pancreatitis is an inflammatory disease of pancreas which comes from various etiologies. The pathologic spectrum of acute pancreatitis varies from mild edematous pancreatitis to severe necrotizing pancreatitis. Diagnosis of acute pancreatitis relies on clinical symptoms and increase of serum lipase and amylase within 48 hours. We report the case of a patient admitted in the pediatric department with about 24 hour history of acute abdominal pain. A computed tomography scan revealed an acute pancreatitis in spite of the serum amylase and lipase level being normal.

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