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Related Experiment Videos

Gas in the pancreatic bed without abscess

W E Torres, J L Clements, P J Sones

    AJR. American Journal of Roentgenology
    |December 1, 1981
    PubMed
    Summary

    Gas within a pancreatic mass can indicate a cystoenteric fistula, not always an abscess. Recognizing this condition can prevent unnecessary surgical intervention for patients with pancreatic inflammatory disease.

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    Area of Science:

    • Gastroenterology
    • Radiology
    • Surgical Pathology

    Background:

    • Pancreatic inflammatory and neoplastic diseases require accurate diagnosis.
    • Gas within a pancreatic mass is often associated with pancreatic abscess.
    • Distinguishing between abscess and other gas-producing conditions is crucial for patient management.

    Observation:

    • Reviewed 259 patients with suspected pancreatic disease.
    • Identified seven patients with gas in a pancreatic mass.
    • Three cases initially suspected as abscess were not confirmed.

    Findings:

    • Two of seven patients with gas had documented pancreatic pseudocyst to bowel fistulae.
    • One patient had no identifiable fistula preoperatively or surgically.
    • Spontaneous cystoenteric fistulae can lead to patient improvement.

    Implications:

    • Awareness of cystoenteric fistulae is vital to avoid unnecessary surgery.
    • Non-toxic patients with gas in pancreatic masses may have fistulae.
    • Radiologic evaluation and percutaneous aspiration can aid in diagnosis and prevent surgical misadventures.

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