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Das SS, Bondok W, Jafri IF, Ghazi DA, AbdelAziz Z. Acute Necrotizing Pancreatitis Following Intragastric Balloon Insertion. Cureus 2024; 16:e54437. [PMID: 38510873 PMCID: PMC10951778 DOI: 10.7759/cureus.54437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Obesity has become a widespread global issue, particularly in the developed world. One popular weight loss technique is the intragastric balloon placement due to its simplicity of insertion and safe nature. While some side effects have been linked to its use, most are benign. However, severe complications do occur in some cases. One such rare complication is pancreatitis due to compression of the pancreas or the pancreatic duct. We encountered an interesting case of necrotizing pancreatitis following gastric balloon insertion, about which scarce data is available in the literature; its incidence is also unknown currently. Our patient was a 22-year-old male with a gastric balloon inserted for obesity eight months before his presentation. The mechanism of the inflammation, the age of the patient, and the progression to necrosis are the compelling aspects of this case.
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Affiliation(s)
| | | | - Iqra F Jafri
- General Surgery, Dubai Medical College, Dubai, ARE
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Venishetty N, Parikh A, Trivedi M, Didia C. Periampullary Diverticula Causing Recurrent Pancreatitis: A Case Report. Cureus 2023; 15:e42189. [PMID: 37601985 PMCID: PMC10439679 DOI: 10.7759/cureus.42189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Acute p-ancreatitis (AP) is increasingly rising globally, especially among elderly populations. In many cases, AP can progress to chronic pancreatitis (CP) and cause damage to the pancreas. Common causes of AP include gallstones and alcoholic injury, but periampullary diverticula (PAD) have emerged as a complex etiology. PADs are rare bowel-filled outpouchings located near the main papilla or common bile duct (CBD). In this study, we present a 66-year-old female with recurrent pancreatitis that is caused by a PAD. Due to the paucity of information regarding the management of PADs, we hope this case highlights the need to advance treatment options in this area.
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Affiliation(s)
- Nikit Venishetty
- Department of Orthopedic Surgery, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Amish Parikh
- Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Meesha Trivedi
- Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
| | - Claudia Didia
- Department of Internal Medicine, Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine, El Paso, USA
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Varda B, Alani M, Ahmed S. A Rare Case of Spontaneous Fungal Peritonitis Caused by Candida lusitaniae in a Patient With Necrotizing Pancreatitis. Cureus 2023; 15:e40237. [PMID: 37435273 PMCID: PMC10332884 DOI: 10.7759/cureus.40237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 07/13/2023] Open
Abstract
Candida lusitaniae is a rare cause of peritonitis most commonly associated with peritoneal dialysis patients. Pancreatitis is one possible cause of ascites with a low serum ascites albumin gradient. Herein, we present a case of spontaneous fungal peritonitis caused by Candida lusitaniae in a patient with necrotizing pancreatitis. The patient was treated with antifungal medication, while her pancreatitis was managed endoscopically with necrosectomy. She improved clinically and was discharged in stable condition.
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Affiliation(s)
- Bianca Varda
- Internal Medicine, St. Joseph's Hospital and Medical Center, Phoenix, USA
- Internal Medicine, Loyola University Medical Center, Chicago, USA
| | | | - Shifat Ahmed
- Gastroenterology, Creighton University School of Medicine, St. Joseph's Hospital and Medical Center, Phoenix, USA
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Creech ZA, Shastri D, Hussain MW, Ikram W, MacElwee M. A Case of Autoimmune Pancreatitis Presenting As Alcohol-Induced Necrotizing Pancreatitis. Cureus 2023; 15:e39616. [PMID: 37388613 PMCID: PMC10300237 DOI: 10.7759/cureus.39616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 07/01/2023] Open
Abstract
Autoimmune pancreatitis (AIP) is an inflammatory condition of the pancreas, commonly characterized by elevated levels of immunoglobulin G (IgG) 4. Diagnosis of this condition can be challenging in patients with risk factors for other pancreatitis etiologies and requires a comprehensive approach utilizing clinical, radiologic, and laboratory findings. Here, we present a case of an individual with a history of multiple prior hospitalizations for alcoholic pancreatitis, who presented with symptoms of abdominal pain, nausea, and vomiting. Computed tomography (CT) imaging revealed intra-abdominal abscesses and findings consistent with pancreatitis. Further laboratory results revealed elevated lipase and IgG4 levels, indicating AIP as the underlying cause. This case highlights the importance of considering AIP as a differential diagnosis in individuals presenting with pancreatic disease.
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Affiliation(s)
- Zachary A Creech
- Department of Internal Medicine, Creighton University School of Medicine, Phoenix, USA
| | - Divya Shastri
- Department of Internal Medicine, Creighton University School of Medicine, Phoenix, USA
| | | | - Waleed Ikram
- Department of Internal Medicine, Creighton University School of Medicine, Phoenix, USA
| | - Mark MacElwee
- Department of Internal Medicine, Valleywise Health Medical Center, Phoenix, USA
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Gidda H, Singh I, Mohamed A, Nashed B. Mild Pancreatitis Induced by Linagliptin Revealed by a Medication Review. Cureus 2023; 15:e36455. [PMID: 37090411 PMCID: PMC10116583 DOI: 10.7759/cureus.36455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
As dipeptidyl peptidase-4 inhibitors are becoming more utilized in the treatment of diabetes, it is important to recognize their side effects and become more familiar with them. As these side effects arise, physicians are more prepared to recognize and discontinue these medications. This case report describes a 34-year-old male who initially presented with a hemoglobin A1c greater than 16%. After titration of his diabetic medications, he presented with pancreatitis diagnosed by symptoms and imaging. Common causes of pancreatitis were ruled out, including biliary pathology, alcohol use, tobacco use, elevated calcium levels, and hypertriglyceridemia. The patient followed up in the clinic with persistent symptoms. A review of his medication list revealed pancreatitis as a side effect of linagliptin. After holding this medication, his symptoms improved over the course of a month.
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Affiliation(s)
- Harish Gidda
- Internal Medicine, Ascension St. John Hospital, Detroit, USA
| | - Inderpal Singh
- Internal Medicine, Ascension St. John Hospital, Detroit, USA
| | - Ayman Mohamed
- Internal Medicine, Ascension St. John Hospital, Detroit, USA
| | - Bola Nashed
- Internal Medicine, Ascension St. John Hospital, Detroit, USA
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Ashraf H, Colombo JP, Marcucci V, Rhoton J, Olowoyo O. A Clinical Overview of Acute and Chronic Pancreatitis: The Medical and Surgical Management. Cureus 2021; 13:e19764. [PMID: 34938639 PMCID: PMC8684888 DOI: 10.7759/cureus.19764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2021] [Indexed: 11/05/2022] Open
Abstract
An inflammatory process involving the pancreas, known as pancreatitis, can be categorized as either acute or chronic and may present in one of many ways. The clinical manifestations of acute pancreatitis are generally limited to epigastric or right upper quadrant pain, while manifestations of chronic pancreatitis are broader and may include abdominal pain in tandem with signs and symptoms of pancreatic endocrine and exocrine insufficiency. An understanding of the initial insult, proper classification, and prognosis are all factors that are of paramount importance as it pertains to managing patients who are afflicted with this disease. Our review delves into the depths of pancreatitis by exploring the embryology and anatomy of the pancreas, the pathophysiology and etiology of acute and chronic pancreatitis, and the medical and surgical management of acute and chronic pancreatitis.
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Affiliation(s)
- Hamza Ashraf
- Medical Education, St. Peter's University Hospital, New Brunswick, USA
| | - John Paul Colombo
- Medical Research, St. Peter's University Hospital, New Brunswick, USA.,Medical Research, St. George's University School of Medicine, True Blue, GRD
| | | | - Jonathan Rhoton
- Surgery, Hackensack University Medical Center, Hackensack, USA
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Sehmbey G, Srinivasan I, Chuang KY. Acute Pancreatitis Due to Clipping of the Ampulla With Over-The-Scope Clip as a Complication of Bleeding Duodenal Ulcer Treatment. Cureus 2020; 12:e8963. [PMID: 32656042 PMCID: PMC7341457 DOI: 10.7759/cureus.8963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/02/2020] [Indexed: 11/21/2022] Open
Abstract
Over-the-scope clips (OTSC) (Ovesco, Tübingen, Germany) are commonly used for closure of bowel perforations, fistulas and to achieve hemostasis. This device is attached to the endoscope and delivers a variety of clips, based on diameter and depth, that works through tissue approximation. Complications including local inflammation, ulcers, or obstruction can occur. When the clip is misplaced or OTSC-associated complications occur, OTSC removal may be indicated. We present a case of a patient who presented to our hospital with upper gastrointestinal (GI) bleeding. OTSC was used to achieve hemostasis, however, the clip was misplaced over the ampulla of Vater. remOVE system (Ovesco, Tübingen, Germany) was used to remove the misplaced clip.
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Affiliation(s)
- Gurbir Sehmbey
- Internal Medicine, Banner University Medical Center, Phoenix, USA
- Internal Medicine, University of Arizona College of Medicine - Phoenix, Phoenix, USA
| | - Indu Srinivasan
- Gastroenterology, Valleywise Health Medical Center, Phoenix, USA
| | - Keng-Yu Chuang
- Internal Medicine/Gastroenterology, Valleywise Health Medical Center, Phoenix, USA
- Internal Medicine/Gastroenterology, Creighton University School of Medicine-Phoenix Program, Phoenix, USA
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