Successful resolution of gastric perforation caused by a severe complication of pancreatic walled-off necrosis:A case report  

作　　者：Byeong Gwan Noh Myunghee Yoon Young Mok Park Hyung-Il Seo Suk Kim Seung Baek Hong Jae Kyun Park Moon Won Lee 

机构地区：[1]Department of Surgery,Pusan National University School of Medicine,Biomedical Research Institute,Pusan National University Hospital,Busan 49241,South Korea [2]Department of Radiology,Pusan National University School of Medicine,Biomedical Research Institute,Pusan National University Hospital,Busan 49241,South Korea [3]Department of Internal Medicine,Pusan National University School of Medicine,Biomedical Research Institute,Pusan National University Hospital,Busan 49241,South Korea

出　　处：《World Journal of Clinical Cases》2023年第26期6298-6303,共6页世界临床病例杂志

基　　金：the Clinical Research Grant from Pusan National University Hospital in 2023.

摘　　要：BACKGROUND Pancreatic walled-off necrosis(WON)rarely causes critical gastric necrosis and perforation,which may develop when pancreatic WON squashes against the stomach.The Atlanta 2012 guidelines were introduced for acute pancreatitis and its related clinical entities.However,there are few reported cases describing the clinical course and resolution of pancreatic WON.CASE SUMMARY We report the case of a 45-year-old man who presented to the urgent emergency department with gastric perforation caused by a severe complication of pancreatic WON on computed tomography.The patient underwent an emergency distal pancreatectomy,splenectomy,and gastric wedge resection.Postoperative findings showed re-perforation of the gastric wall at a previously resected margin.Furthermore,endoscopic examination revealed an ulcerative area with a defect in the fundus.After diagnostic endoscopy,endoscopic vacuum-assisted closure was performed,and continuous suction was transferred over all tissues in contact with the sponge surface.The patient recovered without any further complications and was discharged in good condition at postoperative week 8.No recurrence occurred during the 6-mo follow-up period.CONCLUSION When managing a patient with serious gastric perforation complicated by pancreatic WON,a multidisciplinary treatment approach should be considered.

关 键 词：Acute necrotizing pancreatitis ENDOSCOPY Vacuum assisted closure Gastric rupture Surgery Case report 

分 类 号：R735.7[医药卫生—肿瘤]