Giant Pancreatic Pseudocyst After Coronary Artery Bypass Graft in a Hemodialysis Patient: A Case Report

Overview

Journal Clin Pract

Publisher MDPI

Specialty General Medicine

Date 2023 Oct 27

PMID 37887087

Authors

Ming-Jen Chan

Chun-Yih Hsieh

Yi-Jiun Su

Chien-Chang Huang

Wen-Hung Huang

Cheng-Hao Weng

Tzung-Hai Yen

Ching-Wei Hsu

Affiliations

Soon will be listed here.

Abstract

End-stage renal disease (ESRD) patients have a high prevalence of coronary artery disease, and coronary artery bypass graft (CABG) is one of the essential treatments. ESRD patients undergoing CABG surgery have an increased risk of postoperative complications, including acute pancreatitis. Here, we present the unique case of an exceptionally large pancreatic pseudocyst caused by pancreatitis in an ESRD patient after CABG surgery. A 45-year-old male with ESRD under maintenance hemodialysis received CABG surgery for significant coronary artery disease. Two weeks later, he experienced worsening abdominal pain and a palpable mass was noticed in the epigastric region. Computer tomography revealed an unusually large pseudocyst measuring 21 × 17 cm in the retroperitoneum due to necrotizing pancreatitis. The patient underwent percutaneous cystic drainage, and the symptoms were significantly improved without surgical intervention. Factors such as prolonged cardiopulmonary bypass time, postoperative hypotension, and intradialytic hypotension appeared to have contributed to the development of severe pancreatitis in this case. This report highlights the rarity of a giant pancreatic pseudocyst in an ESRD patient after CABG surgery and emphasizes the importance of vigilant postoperative care.

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