RESUMO
INTRODUCTION: A number of variations in hepatic arterial anatomy have been described. Anomalous arterial supply is of particular relevance to the hepatobiliary, pancreatic or liver transplant surgeon. CASE REPORT: We describe the case of a 57-year-old gentleman who presented with painless obstructive jaundice and was found to have a mass in the head of the pancreas. At pylorus-preserving pancreaticoduodenectomy a distal quadrifurcation of the hepatic artery was discovered. It gave rise to the right hepatic artery, left hepatic artery, intermediate branch and a right accessory hepatic artery. The right accessory hepatic artery gave rise to the gastroduodenal artery. CONCLUSION: The surgeon and interventional radiologist need to be aware of the potential for such aberrant anatomy in order to avoid potentially disastrous complications.
Assuntos
Artéria Hepática/anatomia & histologia , Adenocarcinoma/complicações , Adenocarcinoma/cirurgia , Humanos , Icterícia/etiologia , Icterícia/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/cirurgia , PancreaticoduodenectomiaRESUMO
CONTEXT: Solid pseudopapillary tumour of the pancreas is an uncommon tumour, which predominantly occurs in young females and is of unknown origin. CASE REPORT: We describe five cases with diverse clinical and/or histological features, including one unusually aggressive case resulting in early death. CONCLUSION: There is great variability in the presentation and clinical course of these tumours with further research needed to define their histogenesis and biological behaviour.
Assuntos
Cistadenocarcinoma Papilar/diagnóstico , Pancreatopatias/diagnóstico , Adulto , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/diagnóstico por imagem , Carcinoma Papilar/patologia , Criança , Cistadenocarcinoma Papilar/patologia , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Pancreatopatias/patologia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Prognóstico , CintilografiaRESUMO
CONTEXT: Pancreatic ascites is rare and thought to be due to rupture of a pancreatic pseudocyst, main pancreatic duct disruption or leakage from an unknown site. CASE REPORT: We report the case of a 33-year-old gentleman with a history of chronic alcoholic pancreatitis who presented with pancreatic ascites and was successfully treated with open transduodenal stenting and pancreatic and biliary sphincteroplasty. CONCLUSION: Open transduodenal stenting is an option to failed endotherapy in pancreatic ascites.
