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Case Reports
. 2020 Dec;48(12):300060520977361.
doi: 10.1177/0300060520977361.

Acute pancreatitis after the removal of a hyperplastic duodenal polyp: a case report

Milko Mirchev  1 , Silvia Atanasova  2 , Diana Gancheva  1 , Jens Claus Hahne  3 , Andrei Kotzev  4 , Nikolay Georgiev  1
Affiliations
Case Reports

Acute pancreatitis after the removal of a hyperplastic duodenal polyp: a case report

Milko Mirchev et al. J Int Med Res. 2020 Dec.

Abstract

A 59-year-old patient underwent the duodenal endoscopic mucosal resection of a hyperplastic polyp. Four hours after the procedure she developed severe epigastric pain. Laboratory and imaging results were consistent with mild acute edematous pancreatitis. After several days of dietary therapy and intravenous crystalloid fluids the patient recovered, and 1 month later was asymptomatic and had no signs of pancreatic inflammation. This case illustrates a rare but clinically important complication of therapeutic upper endoscopy, which may be attributable to thermal injury of the duodenal wall and the adjacent pancreas. It also underscores the importance of the close follow up of patients who undergo invasive endoscopic procedures and the need for additional preventive measures to be taken when resecting duodenal lesions.

Keywords: Duodenal polyp; case report; complication; pancreatitis; polypectomy; thermal injury; upper endoscopy.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Endoscopic image of the duodenal polyp after saline infiltration, showing good lifting sign. Equipment used: Olympus Exera II H180 gastroscope, without magnification.
Figure 2.
Figure 2.
Endoscopic image of the same polyp after partial resection. Minimal bleeding is present after the initial excision, which stopped after the complete removal of the lesion. Equipment used: Olympus Exera II H180 gastroscope, without magnification.
Figure 3.
Figure 3.
Abdominal contrast-enhanced computed tomography image, revealing swelling of the pancreatic head (arrow).
See this image and copyright information in PMC

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