Update on Autoimmune Pancreatitis and IgG4-Related Disease.

Autoimmune pancreatitis is an increasingly recognized inflammatory type of subacute pancreatitis; two subtypes of autoimmune pancreatitis have been identified so far: the "lymphoplasmacytic" type 1 variant and the "neutrophilic" type 2 variant. Type 1 autoimmune pancreatitis represents the most common manifestation of IgG4-related disease, a fibro-inflammatory disorder characterized by elevated IgG4 levels in the serum and affected tissues. Type 2 autoimmune pancreatitis is a pancreas-specific disorder that frequently occurs in the context of inflammatory bowel diseases.

Incidental pancreatic cystic lesions: retrospective analysis of natural history and efficacy of imaging surveillance guidelines.

Objectives: To assess the natural history of incidental pancreatic cystic lesions (PCLs) and the sensitivity of surveillance guidelines to detect malignancy.

Materials And Methods: We performed a single-center retrospective analysis of incidental PCLs discovered between 2012 and 2017. Patients were identified by searching radiology reports for relevant keywords, then search results were manually reviewed to exclude patients with < 5 years of follow-up, non-incidental PCLs, known pancreatic cancer, or pancreatitis.

Pancreaticopleural fistula causing recurrent bilateral pleural effusions: A case report.

Rationale: Pancreaticopleural fistula (PPF) is an infrequent etiology of pleural effusion, characterized by nonspecific thoracic symptoms, which often leads to misdiagnosis and subsequent severe complications. Consequently, early diagnosis is crucial for effective management and the prevention of adverse outcomes. This report presents a rare case of PPF causing bilateral pleural effusions, aiming to enhance clinical recognition of this condition.

Mass-forming type 2 autoimmune pancreatitis with upstream dilatation of the main pancreatic duct dilatation: a case report.

Background: Type 2 autoimmune pancreatitis is characterized by multiple or segmental strictures of the main pancreatic duct without upstream dilatation. We encountered a case of mass-forming type 2 autoimmune pancreatitis with upstream main pancreatic duct dilatation that was difficult to diagnose preoperatively using endoscopic ultrasound sonography-guided fine-needle aspiration cytology.

Case Presentation: A 58-year-old Japanese man presented with recurrent acute pancreatitis secondary to a 10-mm pancreatic head tumor.

Mimics of pancreatic neoplasms at cross-sectional imaging: Pearls for characterization and diagnostic work-up.

Interpreting imaging examinations of the pancreas can be a challenge. Several different entities can mimic or mask pancreatic neoplasms, including normal anatomic variants, non-pancreatic lesions, and both acute and chronic pancreatitis. It is important to distinguish these entities from pancreatic neoplasms, as the management and prognosis of a pancreatic neoplasm, particularly adenocarcinoma, have considerable impact on patients.

Biomarker Discovery for Early Detection of Pancreatic Ductal Adenocarcinoma (PDAC) Using Multiplex Proteomics Technology.

Early detection of pancreatic ductal adenocarcinoma (PDAC) can improve survival but is hampered by the absence of early disease symptoms. Imaging remains key for surveillance but is cumbersome and may lack sensitivity to detect small tumors. CA19-9, the only FDA-approved blood biomarker for PDAC, is insufficiently sensitive and specific to be recommended for surveillance.

Magnetic resonance imaging (MRI) and clinical features of different parts of the pancreas involved in acute pancreatitis: a cross-sectional study.

Background: Patients with acute pancreatitis (AP) have different sites of pancreatic involvement. The aim of this study was to investigate the differences in magnetic resonance imaging (MRI) findings and clinical features of different sites of involvement (subtypes) in AP, with a view to complement and complete the classification of AP based on anatomical imaging features.

Methods: We consecutively collected data from inpatients with AP from January 2018 to October 2022 at a tertiary care hospital.

Eosinophilic duodenitis misdiagnosed as acute pancreatitis in a child: a case report.

Background: Eosinophilic Gastrointestinal Disorders beyond Eosinophilic Esophagitis (non-EoE EGIDs) are chronic rare inflammatory disorders characterized by eosinophilic infiltration of the gastrointestinal (GI) tract.

Case Presentation: We report the first pediatric case of eosinophilic duodenitis (one type of the non-EoE EGIDs) with concomitant pancreatic reaction that was misdiagnosed as acute pancreatitis (AP). A 13-year-old girl was admitted to our hospital for a week of abdominal distension, vomiting, and epigastric pain that worsened recently.

Pancreatic pseudocyst after acute pancreatitis in children.

Acute pancreatitis in children is a rare condition; however, the incidence of this acute condition has been increasing over the past few decades. In most cases, acute pancreatitis does not cause severe complications in children, but in some cases, it can be complicated by fluid accumulation, fistulas and vascular pathologies, but the most common complication remains the formation of pseudocysts. This article describes the clinical case of a 11-year-old girl from Lithuania, which effectively illustrates a rare condition in children-acute pancreatitis and its developed complication-the formation of a pancreatic pseudocyst.

Epidemiology of chronic and acute pancreatitis in India (EPICAP-India): protocol for a multicentre study.

Introduction: Acute and chronic pancreatitis (CP) are inflammatory conditions of the pancreas that cause local and systemic complications. The epidemiology of these conditions are not well-known in India.

Methods And Analysis: We describe the protocol and procedures of a multicentre study for delineating the epidemiology of pancreatitis in India.

[Clinical analysis of endoscopic retrograde cholangiopancreatography and stent implantation for the pancreaticobiliary injuries in children].

To investigate the therapeutic effectiveness of endoscopic retrograde cholangiopancreatography (ERCP) and stent implantation in the treatment of pancreaticobiliary injuries in children. A retrospective analysis was conducted on the clinical data of children diagnosed with pancreaticobiliary injury and undergoing ERCP and stent implantation at Beijing Children's Hospital, Capital Medical University from January 2021 to December 2022. Demographic information, clinical data, endoscopic treatment methods, postoperative complications and clinical prognosis of the children were collected.

Clinical Insights and Management Strategies for Acute Obstructive Suppurative Pancreatic Ductitis: A Retrospective Study of 82 Rare Cases.

Background And Aims: Acute obstructive suppurative pancreatic ductitis (AOSPD) is a rare condition with limited diagnostic and treatment information. This study aims to expand understanding by analyzing the clinical characteristics and management of AOSPD.

Methods: We analyzed 81 AOSPD cases (1993-2024) from the literature and 1 case from the First Affiliated Hospital of Anhui Medical University.

An Atypical Case of Acute Pulmonary Embolism in a Sri Lankan Patient With Acute Severe Pancreatitis With Heterozygosity for the SPINK 1 Mutation.

Acute pancreatitis is a disease characterized by local destruction of the pancreatic gland due to premature activation of pancreatic enzymes within the acinar cells. Tissue damage can activate an inflammatory cascade, which can lead to systemic complications. Although vascular complications are uncommon, they significantly contribute to mortality and morbidity.

Complex pancreaticobiliary maljunction diagnosed by endoscopic ultrasound: A case report.

Rationale: This case report aims to enhance understanding of pancreatobiliary maljunction (PBM) and promote more proactive treatment.

Patient Concerns: The patient, a 24-year-old Chinese female, was admitted to the hospital on April 7, 2020, due to "recurrent abdominal pain for over 2 years, with a recent episode accompanied by nausea and vomiting for 1 day." She had a previous history of gallstones.

Emphysematous pancreatitis: Diagnosis, treatment, and prognosis.

Background: Emphysematous pancreatitis (EP) is a rare, severe form of acute necrotizing pancreatitis characterized by gas in pancreatic or peripancreatic tissue, with a high mortality rate.

Aim: To assess the diagnosis, treatment, and outcomes of EP through a series of case studies.

Methods: This case series was conducted in intensive care units at the Second Affiliated Hospital of Anhui Medical University.

Diagnosis of Hereditary Pancreatitis Following the Initial Acute Episode With Multiple Pseudocyst Complications.

Hereditary pancreatitis (HP) is an unusual form of pancreatitis inherited as an autosomal dominant disorder. Patients typically present with recurrent acute pancreatitis-like symptoms that eventually progress to chronic pancreatitis, resulting in pancreatic exocrine insufficiency or diabetes mellitus, and a high risk of developing pancreatic cancer. As such, early diagnosis is crucial.

Diffuse large B-cell lymphoma with rapid kidney enlargement after induction of hemodialysis in a patient with IgG4-related disease.

A 76-year-old Japanese man was incidentally diagnosed with a pancreatic head tumor on computed tomography after surgery for colon cancer. He underwent pancreatoduodenectomy and was diagnosed with IgG4-related autoimmune pancreatitis. Concurrent chronic kidney disease gradually progressed and chronic hemodialysis was introduced 2 years later.

A Rare Case of Autoimmune Pancreatitis in a 9-Year-Old Male Patient: A Comprehensive Diagnosis and Successful Treatment.

Autoimmune pancreatitis (AIP) is a rare and complex condition that can be difficult to identify due to its resemblance to malignancies. This case report presents a unique instance of AIP in a 9-year-old male patient who presented with painless jaundice and elevated liver function test results. His symptoms were persistent even after previous common bile duct stent placement, requiring additional investigation.

Use of Pancreatic Density on Computed Tomography to Predict Postendoscopic Retrograde Cholangiopancreatography Pancreatitis.

Introduction: Postendoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) is a frequent complication, and its pathogenesis remains unclear, with various patient and procedural factors proposed as potential contributors. This study aimed to assess the predictive value of pancreatic to splenic density ratio on computed tomography (CT) for PEP in patients with inadvertent pancreatic duct cannulation.

Methods: This retrospective study involved 2556 patients undergoing ERCP from January 2014 to December 2020.

Permanent pacemaker implantation for atrioventricular block secondary to acute pancreatitis in a patient affected by panhypopituitarism.

Background: Hypopituitarism may trigger the development of acute pancreatitis (AP) through multiple mechanisms. AP may alter normal intracardiac conduction leading to an atrioventricular block. Due to the lack of similar cases, the correct timing and indication for pacemaker implantation in such a setting are unknown.

[Pancreatic cystic neoplasms: work-up and surveillance].

Whereas pancreatic masses are often difficult to detect with transabdominal ultrasound, cross-sectional imaging features high sensitivity for the pancreatic tumors. However, increasing availability of magnetic resonance imaging (MRI) has led to a surge in the detection of benign or precancerous pancreatic lesions. The medical history is characteristic only for two entities.

Endoscopic innovations in diagnosis and management of pancreatic cancer: a narrative review and future directions.

Pancreatic cancer serves as the third leading cause of cancer-associated morbidity and mortality in the United States, with a 5-year survival rate of only 12% with an expected increase in incidence and mortality in the coming years. Pancreatic ductal adenocarcinomas constitute most pancreatic malignancies. Certain genetic syndromes, including Lynch syndrome, hereditary breast and ovarian cancer syndrome, hereditary pancreatitis, familial adenomatous polyposis, Peutz-Jeghers syndrome, familial pancreatic cancer mutation, and ataxia telangiectasia, confer a significantly higher risk.

Optimized FDG-PET/MRI protocol reveals metabolic predictors of long-term survival in pancreatic cancer patients.

Purpose: To optimize and assess an abbreviated dual time-point 18-Fluor-Deoxyglucose (FDG)-Positron Emission Tomography (PET)/Magnetic Resonance Imaging (MRI) protocol for predicting patient outcomes in pancreatic cancer.

Methods: 70 patients (47 pancreatic cancer, 23 chronic pancreatitis) underwent hybrid PET/MRI with dual time-point PET/CT at 60 and 84 minutes post-injection. Metabolic indices (MI) were calculated from Standardized Uptake Value (SUV) changes (SUVmin, SUVmean and SUVmax).

Pancreaticopleural fistula: a rare aetiology of pleural effusion.

Pancreaticopleural fistula (PPF) is a rare complication of chronic pancreatitis, which clinically presents as a pleural effusion and often with an absence of typical abdominal symptoms associated with pancreatic disease.We describe a man in his early 50s who presented to the emergency department with pleuritic chest pain and progressive breathlessness with a history of alcohol excess. Chest X-ray demonstrated a bilateral pleural effusion with a dark red amylase-rich exudate on needle aspiration, necessitating a chest drain insertion.

Protein-losing enteropathy as the first presentation of systemic lupus erythematosus the first case reported in Palestine with systemic review.

Introduction: Systemic lupus erythematosus is a chronic inflammatory disease affecting women, causing gastrointestinal issues like acute pancreatitis, esophagitis, and protein-losing enteropathy. Protein loss is uncommon, but a case study shows protein-losing enteropathy as a first sign.

Importance: Protein-losing enteropathy (PLE) is a rare gastrointestinal manifestation of SLE, often seen years before diagnosis.