Leakage of a Pseudocyst

[SaraB]

I posted on the Oct. 7....more developments
Week 4:
For the latter part of the week he started feeling better, was up and getting around.  It was like there was nothing wrong with him Didn't experience pain
Took a CT Scan on Thursday,with the following results
1)Cysts are bigger, 2 big ones (5cm and 3cm) and multiple others
2)Head, body, and neck of the pancreas inflamation was gone, however
3)Tail is still inflamed with 2 big cysts on tail end
Saturday night, (10-12) all of a sudden a huge onset of pain on his belly.
Majority of the pain is on the right side (when hosptialized, pain on the left)
Blood tests resulted in high amalyse, glucose, and liver levels, high WBC
Did a CT Scan, nothing was found, everything is the same , as we were told
However his pain is as intense as he entered the hopital on 9-14
All his original symptoms are back: the same as when he initially entered the hosptial 9-14
1)Intense pain,fever, high pulse rate, high blood pressure, sugar levels are high
2)Stomach feels like it is on fire
3)Very weak, fatigued, dry...dehydrated
Monday, (10-14)
1st theory of his pain, leakage of the pseudocyst
Ultrasound was done, it showed gallbladder sludge
Enscopy only to the stomach to look for ulcers, found a lot of bile inside the stomach, this was sent to the lab
Results of the sludge, tiny crystals was found
Don't know what caused it,Doctors thought, either a leakage, another pancreatitis flare up, currently debating over
removable of the gall bladder......
Today, Wednesday, 10-16-02.....

[SaraB]

continued....WBC almost back to normal, amylase back to 100, however
he is in pain, very weak, can't even speak
My husband and I are worried that the pancreatic duct is blocked somehow, however the doctor will not do an ERCP.
Saturday, will be 5 weeks total, he has not eaten, nor had anything to drink since he has entered the hospital.

They are waiting for his sugar levels to normalize and vitals as well.  He is given antibiotics....

Can a leakage occur?  
Can he have a flare up eventhough he hasn't gotten over the first attack?
How severe is this?  
Complications that can arise from this?  
Shouldn't he be eating by now...he was his normal self until Saturday

Anybody have any answers?

[Nanny]

It is entirely possible to have another flare up while still recovering from an acute attack.  When conditions are as severe as your husband's case, it is standard procedure to let the pancreas rest and not introduce food or liquids by mouth, sometimes for weeks, until the inflamation is gone.  Is he on TPN?

An ERCP is too invasive of a procedure to be considered at this time.  There is too much possiblity of yet another pancreatitis attack.  Since the pseudocysts are still growing, the doctors probably want to wait until his condition stabilizes before going any further.  It may be that the doctors are considering drainage, but this is normally not done until the pseudocysts stabilize.  It is possible for larger pseudocysts to rupture, yet that would have been seen in the CT-scan on Thursday.  Pseudocysts of this size, with inflamation, are EXTREMELY painful.  Unfortunately, I have experienced this.  I replied two days ago to your earlier message on Oct. 10.  Did you see this post?  Post again if you have any questions.  I have some information on pseudocysts and treatment for this condition if you would like me to send it to you.  It is too long to post on this message board, so I could email it to you if you want to send me your email address.

Nanny
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