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- Title
DIFFICULT CASE OF CHRONIC PANCREATITIS IN YOUNG ADULTS: A WIDE SPECTRUM OF COMPLICATIONS.
- Authors
Iurian, Diana Veronica; Pop, Alexandra Maria; Feghiu, Alisa; Anne-Marie, Enache; Pantea, Monica
- Abstract
Background: Long-term evolution of the Chronic Pancreatitis (CP) include pseudocyst formation, bile duct obstruction, pancreatic cancer, vascular complications, exocrine and endocrine insufficiency. Objectives: The purpose of this paper is to highlight the complexity of Chronic Pancreatitis complications in young adults. Material and methods: We review a case of a 35-year old male, heavy smoker and alcohol consumer, with no history of gastrointestinal diseases, presenting in the medical service with an insidious onset of symptoms: abdominal pain, nausea, loss of weight and appetite. Anamnestic, clinical and imaging data (abdominal ultrasound and CT scan) confirmed the diagnosis of CP complicated with enlarged pseudocysts at the tail and the body of the pancreas. A 70/94 mm body pseudocyst caused symptomatic compression of the hepatic hilum and the duodenum and exploratory laparotomy followed by anterior transgastric cystogastrostomy was performed to drain the pseudocyst into the stomach. Two months later, the patient returned to the hospital accusing persistent abdominal pain. Results: CT scan revealed the presence of Portal Vein Thrombosis (PVT) with cavernoma formation, which had occurred as a late complication of CP. At the current admission, the patient presented with protein calories malnutrition and severe inappetence that has led to 20 kg weight loss since CP was diagnosed, weakness, fatigue and signs of exocrine pancreatic insufficiency such as diarrhea, steatorrhea and abdominal bloating. Upper gastrointestinal endoscopy reveals esophageal varices grade 1 secondary to portal hypertension that occured in the setting of PVT. Conclusions: This case illustrates the fact that CP associates a wide spectrum of severe complications despite the young age of the patient, requiring complex medical approach. As the existing medical literature provides only few case-reports of complicated CP in young adults, this case encourages further investigations.
- Subjects
ESOPHAGEAL varices; CHRONIC pancreatitis; YOUNG adults; EXOCRINE pancreatic insufficiency; ABDOMINAL pain; WEIGHT loss
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p36
- ISSN
2068-3324
- Publication type
Article