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BMC Res Notes. 2017 Sep 6;10(1):450. doi: 10.1186/s13104-017-2799-y.

Pancreas herniation into the mediastinum: a case report.

Author information

1
Department of Internal Medicine, University of Missouri, Kansas City (UMKC), 2411 Holmes Street, Kansas City, MO, 64108, USA. shafiqmu@umkc.edu.
2
Internal Medicine, Jamaica Hospital Medical Center, New York, USA.
3
University of Illinois at Peoria, Peoria, Illinois, USA.
4
Khyber Medical College, Peshawar, KPK, Pakistan.
5
Indiana University School of Medicine, Indianapolis, IN, USA.

Abstract

BACKGROUND:

Pancreatic tissue found in the mediastinum (both true ectopic and herniated pancreas) is rare. It becomes even more challenging when there are complications associated with this entity.

CASE PRESENTATION:

We report an unusual case of pancreatic herniation into the mediastinum in a 90-year-old Caucasian female. This patient initially presented with nausea and vomiting associated with abdominal pain. Serum lipase and amylase both were elevated. Computed tomography scan of the chest, abdomen and pelvis revealed a large hiatal hernia with pancreas herniation into the mediastinum, with superimposed acute pancreatitis likely due to gallstone. Because of its unusual location, the patient also developed acute mediastinitis. The patient was management conservatively and did well. On the day of discharge; she was tolerating a diet, had no pain or nausea and was back to her baseline health.

CONCLUSION:

Acute pancreatitis can be managed conservatively even if it is in the mediastinum. Also, ectopic or herniated pancreatic tissue is extremely rare and leads to unique clinical presentations, along with diagnostic and therapeutic challenges. Clinicians should not only be vigilant to the presence of ectopic or herniated pancreatic tissue, but also be mindful of the resulting complications.

KEYWORDS:

Abdominal pain; Acute pancreatitis; Ectopic pancreas; Herniation; Mediastinum

PMID:
28877730
PMCID:
PMC5588698
DOI:
10.1186/s13104-017-2799-y
[Indexed for MEDLINE]
Free PMC Article

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