Foreign body-induced abscess resembling pancreatic neoplasia

Ann R Garment1, Michael B Schwartz, Kelly M Axsom

  • 1Division of General Internal Medicine, New York University - Langone Medical Center, New York, NY, 10016, USA. ann.garment@nyumc.org

Insights

A pancreatic head mass initially suspected as cancer was actually a foreign body-induced abscess from gastric perforation. This case highlights key differences between pancreatic neoplasia and abscess for accurate diagnosis and management.

Area of Science:

  • Gastroenterology
  • Radiology
  • Surgical Pathology

Background:

  • Pancreatic head masses can present diagnostic challenges, mimicking malignancy.
  • Foreign body ingestion leading to gastric perforation is a rare but critical cause of intra-abdominal abscesses.

Observation:

  • A 44-year-old man presented with abdominal pain and leukocytosis, with initial CT suggesting pancreatic adenocarcinoma.
  • Further imaging review revealed the pancreatic head mass to be an abscess secondary to a gastric perforation from ingested foreign material.

Findings:

  • Distinguishing between pancreatic neoplasia and abscess requires careful clinical and radiographic evaluation.
  • Gastric perforation, even from foreign bodies, can lead to complex presentations mimicking primary pancreatic pathology.

Implications:

  • Accurate differentiation is crucial for appropriate patient management and prognosis.
  • Understanding the sequelae of viscus perforations is vital for surgical and medical interventions.
  • This case underscores the importance of comprehensive imaging review in diagnosing abdominal pathologies.

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