Pancreatic Exocrine Insufficiency in Intraductal Papillary Mucinous Carcinoma Presenting with Leg Edema Treated with Pancreatic Exocrine Replacement Therapy

• Published in: Internal Medicine Vol. 61; no. 13; pp. 1963 - 1967
• Main Authors: Tanaka, Emi, Ogawa, Tsuneyoshi, Tsutsumi, Koichiro, Kobayashi, Sayo, Nawa, Toru, Ueki, Toru, Okada, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 01-07-2022; Japan Science and Technology Agency
• Subjects: Activities of daily living; Adenocarcinoma; Ascites; Case Report; Computed tomography; Cytology; Diuretics; Edema; Internal medicine; intraductal papillary mucinous carcinoma; intraductal papillary mucinous neoplasm; Leg; leg edema; Pancreas; pancreatic cancer; pancreatic exocrine insufficiency; pancrelipase; Pleural effusion
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8611-21

An 89-year-old woman underwent examinations for leg edema. Blood tests indicated low nutrition and low pancreatic enzymes, and a stool examination indicated fatty stool. Computed tomography showed pleural effusion, ascites, and cystic lesions in the pancreatic head and mural nodules within the cysts. Pancreatic juice cytology revealed adenocarcinoma. The diagnosis was pancreatic exocrine insufficiency caused by intraductal papillary mucinous carcinoma. The patient did not wish to undergo surgery. Therefore, diuretics, component nutrients, and pancreatic exocrine replacement therapy using pancrelipase were initiated. After starting treatment, her leg edema, pleural effusion, and ascites disappeared, and her activities of daily living improved markedly.