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Xanthogranulomatous pancreatic abscess secondary to acute pancreatitis: two case reports

Takehiro Okabayashi1, Isao Nishimori, Michiya Kobayashi

  • 1Department of Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.

Hepato-Gastroenterology
|November 21, 2007
PubMed

Insights

Xanthogranulomatous pancreatic abscesses are rare, often following acute pancreatitis and infection. Prolonged infection and hypoperfusion may cause these inflammatory changes, requiring surgical intervention.

Area of Science:

  • Gastroenterology
  • Pathology

Background:

  • Xanthogranuloma is a rare inflammatory condition with limited reported cases in the pancreas.
  • Pancreatic abscesses can arise secondary to acute pancreatitis, presenting complex clinical challenges.

Observation:

  • Two cases of xanthogranulomatous pancreatic abscess following acute pancreatitis are presented.
  • Both cases involved infected pancreatic tail pseudocysts with bacterial and fungal species.
  • Vascular complications, including arterial obliteration and splenic artery occlusion, were noted in the affected pancreatic tails.

Findings:

  • Pathologic examination revealed xanthogranulomatous inflammation surrounding the pancreatic tail and spleen in both patients.
  • Distal pancreatectomy was necessary due to resistance to conventional antibiotic therapy.
  • Hypoperfusion and prolonged infection are hypothesized as causative factors for xanthogranulomatous changes.

Implications:

  • This report highlights a rare manifestation of pancreatic inflammation.
  • Understanding the pathogenesis may guide future treatment strategies for complex pancreatic infections.
  • Further research is needed to elucidate the role of hypoperfusion and infection in xanthogranulomatous pancreatic inflammation.

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