ArticleDigestive diseases and sciences2026
Directional Patterns in Ruptured Pancreatic Fluid Collections: A Ten-Patient Case Series and Proposed Framework for Management.
Article in Digestive diseases and sciences, 2026. 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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7 authors.
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Abstract
backgroundRupture of pancreatic fluid collections (PFC) is a rare but high-stakes complication of necrotizing pancreatitis, and its clinical trajectory varies markedly with the anatomical direction of rupture; a directional framework linking rupture pattern to expected clinical course and management is currently lacking.
aimsTo characterize the spectrum of anatomical rupture patterns in patients with PFC and to propose a practical framework for anticipating clinical course and guiding management.
methodsWe retrospectively reviewed ten patients with confirmed PFC rupture at a tertiary center, evaluating presentation, imaging, multidisciplinary intervention, and outcome.
resultsAll patients were male. Five directional patterns emerged: duodenal, colonic, biliary, thoracic, and vascular-portal, each with a distinct clinical signature and prognosis. Duodenal rupture generally produced favorable spontaneous decompression; colonic involvement was associated with inflammatory erosion, pseudoaneurysm formation, and the majority of adverse outcomes in this series; biliary communication required combined endoscopic, radiological, and surgical decompression; thoracic extension reflected underlying pancreatic ductal disruption; and vascular-portal rupture, a previously underdescribed pattern, produced portal vein thrombosis, portal biliopathy, and fatal sepsis. Management drew on tailored combinations of endoscopic, radiological, endovascular, and surgical techniques.
conclusionsWe propose a direction-based framework to help anticipate clinical course and guide management of this unpredictable complication.
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