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DOI: 10.1055/s-0044-1792132
Pseudocyst-Portal Vein Fistula with Hepatic Pseudocysts as Life-Threatening Complication of Pancreatitis: A Case Series with Review of Literature
Funding None.

Abstract
Pseudocyst-portal vein fistula (PPVF) manifesting as hepatic pseudocyst is a very rare vascular complication of pancreatitis. We present three cases of pancreatitis manifesting as PPVF with hepatic pseudocyst. One of them had a symptomatic pseudocyst with nonpatent portal vein with sepsis, which was managed with endoscopic drainage. The second case had a symptomatic pseudocyst with nonpatent portal vein without any manifestation of sepsis or gastrointestinal (GI) bleed, which was managed conservatively with gradual improvement. The third case manifested with sepsis with organ failure and GI bleed; portal vein reconstruction was planned, but the patient succumbed to sepsis. During a follow-up of 12 months, the first two patients had an uncomplicated course. Patency of the portal vein played a key role in determining the further course of treatment. In case of a nonpatent portal vein, endoscopic drainage may be preferred in case of symptomatic patients, whereas asymptomatic patients may be managed conservatively.
Publikationsverlauf
Artikel online veröffentlicht:
16. Dezember 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Kalas MA, Leon M, Chavez LO, Canalizo E, Surani S. Vascular complications of pancreatitis. World J Clin Cases 2022; 10 (22) 7665-7673
- 2 Makary MS, Gayou EL, Kyrouac D, Shah ZK. Pancreaticoportal fistula formation as a consequence of recurrent acute pancreatitis: clinical and imaging considerations. J Clin Imaging Sci 2018; 8: 4
- 3 Raza SS, Hakeem A, Sheridan M, Ahmad N. Spontaneous pancreatic pseudocyst-portal vein fistula: a rare and potentially life-threatening complication of pancreatitis. Ann R Coll Surg Engl 2013; 95 (01) e7-e9
- 4 Liu W, Du J-J, Li Z-H, Zhang X-Y, Zuo H-D. Liver injury associated with acute pancreatitis: The current status of clinical evaluation and involved mechanisms. World J Clin Cases 2021; 9 (34) 10418-10429
- 5 Molina H, Chan MM, Lewandowski RJ, Gabr A, Riaz A. Complications of percutaneous biliary procedures. Semin Intervent Radiol 2021; 38 (03) 364-372
- 6 Yamamoto T, Hayakawa K, Kawakami S. et al. Rupture of a pancreatic pseudocyst into the portal venous system. Abdom Imaging 1999; 24 (05) 494-496
- 7 Chang L-H, Francoeur L, Schweiger F. Pancreaticoportal fistula in association with antiphospholipid syndrome presenting as ascites and portal system thrombosis. Can J Gastroenterol 2002; 16 (09) 601-605
- 8 Hammar A-M, Sand J, Lumio J. et al. Pancreatic pseudocystportal vein fistula manifests as residivating oligoarthritis, subcutaneous, bursal and osseal necrosis: a case report and review of literature. Hepatogastroenterology 2002; 49 (43) 273-278
- 9 Riddell A, Jhaveri K, Haider M. Pseudocyst rupture into the portal vein diagnosed with MRI. Br J Radiol 2005; 78 (927) 265-268
- 10 Yoon SE, Lee Y-H, Yoon K-H, Choi CS, Kim H-C, Chae KM. Spontaneous pancreatic pseudocyst-portal vein fistula presenting with pancreatic ascites: strength of MR cholangiopancreatography. Br J Radiol 2008; 81 (961) e13-e16
- 11 Dawson BC, Kasa D, Mazer MA. Pancreatic pseudocyst rupture into the portal vein. South Med J 2009; 102 (07) 728-732
- 12 Noh R, Kim HJ. A pancreatic pseudocyst-portal vein fistula closed by endoscopic pancreatic stent insertion. Gastrointest Endosc 2010; 72 (05) 1103-1105
- 13 Horino K, Takamori H, Ikuta Y. et al. Pancreatic pseudocyst-portal vein fistula. Open J Gastroenterol 2012; 02 (03) 143-144
- 14 Alessandrino F, Strickland C, Mojtahed A, Eberhardt SC, Mortele KJ. Clinical and cross-sectional imaging features of spontaneous pancreatic pseudocyst-portal vein fistula. Clin Imaging 2017; 44: 22-26
- 15 Eccles J, Wiebe E, D'Souza P, Sandha G. Pancreatic pseudocyst-portal vein fistula with refractory hepatic pseudocyst: Two cases treated with EUS cyst-gastrostomy and review of the literature. Endosc Int Open 2019; 7 (01) E83-E86
- 16 Jee KN. Pancreatic pseudocyst-portal vein fistula: serial imaging and clinical follow-up from pseudocyst to fistula. J Korean Soc Radiol 2015; 72 (03) 180
- 17 Masuda S, Koizumi K, Uojima H. et al. Pancreatic pseudocyst-portal vein fistula: a case treated with EUS-guided cyst-drainage and a review of the literature. Clin J Gastroenterol 2020; 13 (04) 597-606
- 18 Ng TSC, Rochefort H, Czaplicki C. et al. Massive pancreatic pseudocyst with portal vein fistula: case report and proposed treatment algorithm. Pancreatology 2015; 15 (01) 88-93