We have experienced a case of severe acute pancreatitis with a pancreatic cancer which was detecyted at autopsy.
A 67-year-old man developed severe acute pancreatitis after repeated attacks of acute pancreatitis. The clinical course after onset of severe acute pancreatitis was the same as usual severe acute pancreatitis, and despite laparotomic drainage the patient died of multiple organ failure. At autopsy, a pseudocyst of the pancreas 2cm in diameter was confirmed in the body of the pancreas which was associated with a tumor in the cyst that occluded the main pancreatic duct. And a caudal portion of the pancreatic duct from the cyst significantly dilated. Histologically the tumor was moderately differentiated adenocarcinoma. From these findings, it was thought that the occlusion of the pancreatic duct due to the pancreatic cancer caused severe acute pancreatitis.
We rarely encounter clinical cases of pancreatic cancer causing acute pancreatitis, especially those causing severe acute pancreatitis. Pancreatitis following pancreatic cancer generally manifests a form of chronic pancreatitis, but there are some cases presenting severe acute pancreatitis like this case. This possibility should be entertained in the treatment of severe acute pancreatitis.