Small bowel obstruction secondary to impacted pancreatic necrosum through a spontaneous duodenal fistula: a first in the literature.

Dora Laczko, Stephanie Skanes, David Hocking, David Peck, Jeffrey D Hawel, Richard Hilsden

Abstract readCase Reports

In one paragraph

Article in Journal of surgical case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Dora LaczkoDepartment of Surgery, Western University, London Health Sciences Centre, Victoria Hospital, 800 Commissioners Rd., Rm E4-112 London, ON N6A 5W9, Canada.

Stephanie SkanesDepartment of Surgery, Western University, London Health Sciences Centre, Victoria Hospital, 800 Commissioners Rd., Rm E4-112 London, ON N6A 5W9, Canada.

David HockingDepartment of Medical Imaging, Western University, London Health Sciences Centre, Victoria Hospital, 800 Commissioners Rd., Rm E4-112 London, ON N6A 5W9, Canada.

David PeckDepartment of Medical Imaging, Western University, London Health Sciences Centre, Victoria Hospital, 800 Commissioners Rd., Rm E4-112 London, ON N6A 5W9, Canada.

Jeffrey D HawelDepartment of Surgery, Western University, London Health Sciences Centre, Victoria Hospital, 800 Commissioners Rd., Rm E4-112 London, ON N6A 5W9, Canada.

Richard HilsdenDepartment of Surgery, Western University, London Health Sciences Centre, Victoria Hospital, 800 Commissioners Rd., Rm E4-112 London, ON N6A 5W9, Canada.ORCID https://orcid.org/0000-0003-3111-3182

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A 58-year-old man presented with alcohol-induced acute pancreatitis. Imaging revealed complete necrosis of the pancreatic parenchyma. After initial non-operative management, the patient developed a duodenal ulcer and an upper gastrointestinal bleed and later spontaneously formed a fistula between the pancreas and the first segment of the duodenum. Through this fistula, the entire pancreatic necrosum migrated to the distal small bowel, where it became entrapped as a bezoar, causing a high-grade small bowel obstruction. The patient then proceeded to laparotomy, where the obstruction was resolved by removing the necrosum through an enterotomy. No surgical intervention to the pancreatic bed or duodenum was required, and he was ultimately discharged home on insulin and pancreatic enzymes. This is the first reported case in the medical literature of a spontaneous duodenal fistula leading to small bowel obstruction due to a bezoar of pancreatic necrosum.

Indexed as

bezoarbowel obstructiondiagnostic imagingendoscopygeneral surgerypancreaspancreatitis

Identifiers

PMID39606053

DOI10.1093/jscr/rjae739

PMCPMC11602238

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