Pancreatic Pseudocysts and Parenchymal Necrosis in Patients with Autoimmune Pancreatitis: A Systematic Review

Jean A. Donet, Jodie A. Barkin, Tara Keihanian, Zsuzsanna Nemeth, Jamie S Barkin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective To investigate the prevalence and natural history of pancreatic pseudocysts (PCs) and parenchymal necrosis in autoimmune pancreatitis (AIP). Method A search using PubMed, Embase, Scopus, and Cochrane was performed. Search terms were AIP, PC, acute fluid collection, and pancreatic necrosis. Results Fifteen studies with 17 patients were included. In 8 of 17 patients, PC was noted concurrently with the AIP diagnosis, whereas in the other half, PC appeared months or years after. In 10 of 17 cases, PC appeared as solitary. The location was variable. Pseudocysts were small (<3 cm) in 4 cases and large (>3 cm) in 13 cases. A normal pancreatic duct was observed in 6 of 17 cases, whereas 9 of 17 had pancreatic duct stenosis. Steroids were given to 4 of 4 small and 10 of 13 large PC. All small PC resolved with steroids, whereas only 4 of 10 large PC treated had some response. Most (9/13) of large PC underwent endoscopic or surgical procedures. None of the 17 cases developed necrosis. Conclusions Pseudocysts in AIP are rare. Pancreatic pseudocyst can present in variable number, size, and location. Small PC resolved with steroids. Large PC had poor response to steroids requiring invasive interventions. Necrosis in AIP has not been reported.

Original languageEnglish (US)
Pages (from-to)952-957
Number of pages6
JournalPancreas
Volume47
Issue number8
DOIs
StatePublished - Sep 1 2018

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Pancreatic Pseudocyst
Pancreatitis
Necrosis
Steroids
Pancreatic Ducts
PubMed
Endoscopy
Pathologic Constriction

Keywords

  • autoimmune pancreatitis
  • pancreatic pseudocyst
  • parenchymal necrosis

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

Pancreatic Pseudocysts and Parenchymal Necrosis in Patients with Autoimmune Pancreatitis : A Systematic Review. / Donet, Jean A.; Barkin, Jodie A.; Keihanian, Tara; Nemeth, Zsuzsanna; Barkin, Jamie S.

In: Pancreas, Vol. 47, No. 8, 01.09.2018, p. 952-957.

Research output: Contribution to journalArticle

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AB - Objective To investigate the prevalence and natural history of pancreatic pseudocysts (PCs) and parenchymal necrosis in autoimmune pancreatitis (AIP). Method A search using PubMed, Embase, Scopus, and Cochrane was performed. Search terms were AIP, PC, acute fluid collection, and pancreatic necrosis. Results Fifteen studies with 17 patients were included. In 8 of 17 patients, PC was noted concurrently with the AIP diagnosis, whereas in the other half, PC appeared months or years after. In 10 of 17 cases, PC appeared as solitary. The location was variable. Pseudocysts were small (<3 cm) in 4 cases and large (>3 cm) in 13 cases. A normal pancreatic duct was observed in 6 of 17 cases, whereas 9 of 17 had pancreatic duct stenosis. Steroids were given to 4 of 4 small and 10 of 13 large PC. All small PC resolved with steroids, whereas only 4 of 10 large PC treated had some response. Most (9/13) of large PC underwent endoscopic or surgical procedures. None of the 17 cases developed necrosis. Conclusions Pseudocysts in AIP are rare. Pancreatic pseudocyst can present in variable number, size, and location. Small PC resolved with steroids. Large PC had poor response to steroids requiring invasive interventions. Necrosis in AIP has not been reported.

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