Published online Oct 10, 2017. doi: 10.5306/wjco.v8.i5.420
Peer-review started: June 6, 2017
First decision: June 27, 2017
Revised: July 5, 2017
Accepted: August 16, 2017
Article in press: August 17, 2017
Published online: October 10, 2017
Processing time: 114 Days and 4.4 Hours
Here we report a patient diagnosed with small cell lung cancer after first presenting with parathyroid hormone-related peptide-induced hypercalcemic pancreatitis and developed walled-off necrosis that resulted in disruption of the main pancreatic duct. Disconnected duct syndrome (DDS) is a rare syndrome that occurs when the main pancreatic duct exocrine flow is disrupted resulting in leakage of pancreatic enzymes and further inflammatory sequela. To date, no prior reports have described DDS occurring with paraneoplastic reactions. Diagnostic imaging techniques and therapeutic interventions are reviewed to provide insight into current approaches to DDS.
Core tip: Acute recurrent pancreatitis flares should raise concern for disconnected duct syndrome (DDS). This case is the first reported case of DDS caused by paraneoplastic hypercalcemia. Paraneoplastic syndromes may predispose patients to prolonged hypercalcemic pancreatitis and in turn, may predispose patients to DDS. Furthermore, this case report reviews the current approach and treatment difficulties of DDS as well as pancreatic walled-off necrosis.