TWO CASES OF RUPTURED PANCREATIC PSEUDOCYST CAUSED BY ALCOHOL INDUCED CHRONIC PANCREATITIS

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  • アルコール性慢性膵炎に伴う膵仮性嚢胞破裂の２例

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We report two cases of ruptured pseudocyst of the pancreas caused by alcohol induced chronic pancreatitis, in which we were able to follow the enlargement of a pseudocyst with time until its rupture in both cases. Case 1 : A pancreatic pseudocyst enlarged and ruptured that reguired an emergency operation for immediately developed pan-peritonitis despite under medication. The remnant wall of the pseudocyst and surrounding peritoneum were anastomosed with the jejunum, which followed a good clinical course. The amylase value of the discharge from a decompression tube placed in the anastomosis was not high, so that the pseudocyst and main pancreatic duct might not connect with each other. Case 2 : While a pancreatic pseudocyst became larger under medical treatment, no peritoneal irritation sign emerged immediately after rupture. A few days later, however, Percutaneous drainage was needed to treat peritonitis. The pancreatic pseudocyst was confirmed to connect to the main pancreatic duct by fistelography using a drainage tube.<br>The clinical results of pancreatic pseudocysts vary depending on whether they have arisen with or without infection, and with or without communication with the main pancreatic duct. In the case of an enlarging pseudocyst with infection, prompt drainage of the cyst should be most important.

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