A case of severe acute pancreatitis caused by intraductal papillary mucinous neoplasm involving the main pancreatic duct

Abstract

A 57-year-old man was admitted to our hospital due to abdominal pain. At admission, CT grade was IV, TP 5.4 g/dl, and PO₂ (room air) 59.7 mmHg, and the patient was diagnosed as severe acute pancreatitis. The symptoms improved by the administration of protease inhibitors and antibiotics, and the patient was discharged. Follow-up CT showed a multilocular cystic lesion with a solid component in the pancreatic tail. Endoscopic retrograde cholangiopancreatography showed main pancreatic duct dilation and communication with the cyst, and a radiolucent area in the communicating cyst. The patient was diagnosed as intraductal papillary mucinous neoplasm (IPMN), and 3 months after diagnosis, he underwent distal pancreatectomy. Physicians should be cognizant that IPMN involving the main pancreatic duct may cause severe acute pancreatitis.