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Case Reports
. 2023 Aug 3;16(8):e252950.
doi: 10.1136/bcr-2022-252950.

Pancreatitis with infected pseudocyst presenting as a prevertebral abscess with spontaneous rupture into the oesophagus

Madan Shivakumar  1 , Sagar Prakash  1 , Oseen Hajilal Shaikh  1 , Uday Shamrao Kumbhar  2
Affiliations
Case Reports

Pancreatitis with infected pseudocyst presenting as a prevertebral abscess with spontaneous rupture into the oesophagus

Madan Shivakumar et al. BMJ Case Rep. .

Abstract

The development of a prevertebral abscess due to an infected pancreatic pseudocyst and its spontaneous rupture into the oesophagus is a rare complication. We report a man who presented with odynophagia, dyspnoea and abdominal pain. Contrast-enhanced CT showed evidence of pancreatitis and a prevertebral space abscess communicating with the pancreas through the oesophageal hiatus. The patient was diagnosed to have a prevertebral abscess with chronic pancreatitis. Surgical drainage was planned, but the patient died of spontaneous drainage of the prevertebral abscess into the oesophagus and aspiration of the collection into the lungs.

Keywords: Gastrointestinal system; Infection (gastroenterology); Pancreatitis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) X-ray of the neck (lateral view) showing increased prevertebral shadowing and (B) X-ray of the chest (posteroanterior view) showing widened mediastinum.
Figure 2
Figure 2
CT scan of the abdomen showing peripancreatic inflammation (yellow arrow) and a dilated main pancreatic duct (blue arrow).
Figure 3
Figure 3
CT scan of the chest (axial view) showing (A) prevertebral space collection with air foci (yellow arrow) and bilateral pleural effusion (blue arrows) and (B) no evidence of oesophageal perforation (oral contrast marked with yellow arrow). (C) Diagram of the thorax and abdomen (sagittal view): prevertebral space collection (blue arrow) with air foci (yellow arrow), T1 vertebra (yellow asterisk), pancreas (brown arrow) with probable direction of the spread and rupture of the pseudocyst (long yellow arrow) and duodenum (green arrow). (Diagram drawn by author OHS).
Figure 4
Figure 4
(A) CT scan of the chest (coronal view) showing prevertebral space collection with air foci (yellow arrows). (B) Diagram of the thorax and abdomen (coronal view): prevertebral space collection (blue arrow) with air foci (yellow arrow), T1 vertebra (red arrow), T10 vertebra (brown arrow) and spleen (green arrow). (Diagram drawn by author OHS).
See this image and copyright information in PMC

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