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Abstract：
UNASSIGNED: This is the first case of idiopathic giant pancreatic pseudocyst (IGPP) causing intestinal occlusion, intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) reported in the literature. Diagnosis of IGPP in emergency is a challenge because of its rarity and the absence of a history of pancreatitis or pancreatic trauma and specific clinical presentation. Abdominal contrast-enhanced computed tomography (CECT) represents the gold standard in diagnosing of pancreatic cyst (PP). Different types of treatment of PP are reported in the literature.
METHODS: A 52-year-old Caucasian female was admitted to the Emergency Department with a three-day history of abdominal pain, inability to pass gas or stool, nausea and vomiting, oliguria and a seven-day history of abdominal swelling and swollen legs. Physical examination revealed abdominal distention, abdominal pain, swelling in the legs. CECT showed a voluminous cystic pancreatic mass suspected of neoplasm. Laboratory tests reported high serum levels of BUN, creatinine and C-reactive protein and neutrophilic leukocytosis. After preoperative diagnosis of ACS, the patient was taken to the operating room for pancreatic resection. The postoperative course was uneventful. Diagnosis of IGPP was made by histopathological examination.
UNASSIGNED: IGPP is difficult to diagnose in emergency. Although different types of drainage of IGPP are described in the literature, pancreatic resection represents the treatment of choice when a cystic pancreatic neoplasm cannot be excluded.
CONCLUSIONS: IGPP is a rare disease that may cause intestinal occlusion, IAH and ACS. Pancreatic resection if necessary is safe and therapeutic with acceptable morbidity and mortality.
METHODS: A 52-year-old Caucasian female was admitted to the Emergency Department with a three-day history of abdominal pain, inability to pass gas or stool, nausea and vomiting, oliguria and a seven-day history of abdominal swelling and swollen legs. Physical examination revealed abdominal distention, abdominal pain, swelling in the legs. CECT showed a voluminous cystic pancreatic mass suspected of neoplasm. Laboratory tests reported high serum levels of BUN, creatinine and C-reactive protein and neutrophilic leukocytosis. After preoperative diagnosis of ACS, the patient was taken to the operating room for pancreatic resection. The postoperative course was uneventful. Diagnosis of IGPP was made by histopathological examination.
UNASSIGNED: IGPP is difficult to diagnose in emergency. Although different types of drainage of IGPP are described in the literature, pancreatic resection represents the treatment of choice when a cystic pancreatic neoplasm cannot be excluded.
CONCLUSIONS: IGPP is a rare disease that may cause intestinal occlusion, IAH and ACS. Pancreatic resection if necessary is safe and therapeutic with acceptable morbidity and mortality.
摘要：
■这是首例特发性巨大胰腺假性囊肿（ICPP）引起肠闭塞，文献报道了腹腔高压（IAH）和腹腔室隔综合征（ACS）。急诊IGPP的诊断是一个挑战，因为它很罕见，没有胰腺炎或胰腺外伤的病史和特定的临床表现。腹部对比增强计算机断层扫描（CECT）是诊断胰腺囊肿（PP）的金标准。文献中报道了不同类型的PP处理。
方法：一名52岁的白种人女性因腹痛3天的病史进入急诊科，无法通过气体或粪便，恶心和呕吐，少尿和7天腹部肿胀和腿部肿胀的病史。体格检查显示腹胀，腹痛,腿部肿胀。CECT显示大量的囊性胰腺肿块，怀疑是肿瘤。实验室测试报告血清BUN水平高，肌酐和C反应蛋白和嗜中性白细胞增多。术前诊断ACS后，患者被带到手术室进行胰腺切除术。术后病程顺利。通过组织病理学检查诊断为IGPP。
■ICPP在紧急情况下很难诊断。尽管文献中描述了不同类型的ICPP排水，当不能排除囊性胰腺肿瘤时,胰腺切除术是首选的治疗方法.
结论：IGPP是一种罕见的疾病，可能会导致肠道阻塞，IAH和ACS。如有必要,胰腺切除是安全的和治疗性的,具有可接受的发病率和死亡率。
方法：一名52岁的白种人女性因腹痛3天的病史进入急诊科，无法通过气体或粪便，恶心和呕吐，少尿和7天腹部肿胀和腿部肿胀的病史。体格检查显示腹胀，腹痛,腿部肿胀。CECT显示大量的囊性胰腺肿块，怀疑是肿瘤。实验室测试报告血清BUN水平高，肌酐和C反应蛋白和嗜中性白细胞增多。术前诊断ACS后，患者被带到手术室进行胰腺切除术。术后病程顺利。通过组织病理学检查诊断为IGPP。
■ICPP在紧急情况下很难诊断。尽管文献中描述了不同类型的ICPP排水，当不能排除囊性胰腺肿瘤时,胰腺切除术是首选的治疗方法.
结论：IGPP是一种罕见的疾病，可能会导致肠道阻塞，IAH和ACS。如有必要,胰腺切除是安全的和治疗性的,具有可接受的发病率和死亡率。
