Necrotizing Pancreatitis Associated With an Ingested Screw Adjacent to the Ampulla of Vater
Francis Sangwon Lee1, Christina Lee2, Clare Lee3
1Department of General Surgery, Sutter Coast Hospital, Crescent City, CA.
Abstract:
A 78-year-old man presented with severe epigastric pain and was diagnosed with acute pancreatitis that progressed to necrotizing pancreatitis despite supportive management. No common etiologies were identified. During endoscopic nasojejunal feeding tube placement, a metallic screw was incidentally discovered in the second portion of the duodenum adjacent to the major papilla and successfully removed. The foreign body had not been detected on previous computed tomography, ultrasound, or abdominal radiography. The patient recovered completely without recurrence. This case highlights a rare periampullary foreign body in otherwise unexplained pancreatitis and raises the possibility of a mechanical contribution to disease pathogenesis.
Related Concept Videos
01:25Acute Pancreatitis I: Introduction
01:27Acute Pancreatitis I: Introduction
Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:
01:21Acute Pancreatitis II: Pathophysiology
01:25Chronic Pancreatitis I: Introduction
01:24Chronic Pancreatitis I: Introduction
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
01:30Acute Pancreatitis II: Clinical Manifestations and Management