Clinical characteristics of intraductal papillary mucinous neoplasm manifesting as acute pancreatitis or acute recurrent pancreatitis. Issue 4 (25th March 2013)

• Record Type: Journal Article
• Authors: Jang, Ji Woong; Kim, Myung‐Hwan; Jeong, Seung Uk; Kim, Jeongseok; Park, Do Hyun; Lee, Sang Soo; Seo, Dong‐Wan; Lee, Sung‐Koo; Kim, Jin Hee
• Is Part Of: Journal of gastroenterology and hepatology. Volume 28:Issue 4(2013:Apr.)
• Page Start: 731
• Page End: 738
• Publication Date: 2013-03-25
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12121
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12121-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Comparatively little is known about acute pancreatitis or acute recurrent pancreatitis (AP/ARP) with intraductal papillary mucinous neoplasm of the pancreas (IPMN) as the causative lesion although there have been many reports about the malignant potential of IPMN as a premalignant lesion.</p> </sec> <sec id="jgh12121-sec-0002" sec-type="section"> <title>Methods</title> <p>From 2000 to 2008, in a single tertiary referral center, out of 784 patients coded by the International Classification of Disease‐10 with IPMN, 489 patients fulfilled our diagnostic criteria of IPMN. After careful exclusion of all known causes of AP/ARP, 34 patients with IPMN as the cause of AP/ARP were enrolled.</p> </sec> <sec id="jgh12121-sec-0003" sec-type="section"> <title>Results</title> <p>AP/ARP caused by IPMN occurred in 34 (7%) out of 488 patients with IPMN, and the prevalence rate of AP/ARP was higher in the main‐duct/combined type than in the branch‐duct type (14% [16/111] <italic>vs</italic> 5% [18/378], respectively, <italic>P</italic> = 0.002). The severity of pancreatitis was mild, based on the computed tomography severity index score (median 2, range 0–4). Histologic review of 24 patients with surgical resection revealed four adenomas (17%), 17 borderline malignancies (71%), two carcinomas <italic>in situ</italic> (8%), and one invasive carcinoma (4%). AP/ARP did not recur in any of the 24 surgically resected patients during the follow‐up period (median 52 months, range 38–115 months).</p> </sec> <sec id="jgh12121-sec-0004" sec-type="section"> <title>Conclusions</title> <p>AP/ARP caused by IPMN was of infrequent occurrence. AP/ARP caused by IPMN occurred more frequently in the main‐duct/combined type than in the branch‐duct type. Most cases were mild in severity and benign in histopathology. AP/ARP can be an initial manifestation of IPMN, though uncommon, which leads to diagnosis.</p> </sec> </abstract>