Intrapancreatic pseudocyst formation: a complication of acrylate pancreatic duct obliteration.

The case of a young woman is presented who, at the age of 33 years, had surgical occlusion of the pancreatic duct by instillation of acrylate glue for chronic relapsing pancreatitis. She presented in mid-1979, after a period of increasing frequency and severity of pain, with intractable narcotic dependency, and was shown to have a pseudocyst in the head of the pancreas. Distal pancreatic resection and cystoenterostomy have resulted in loss of narcotic dependency and a return to reasonably good health, in spite of a late development of insulin-dependent diabetes mellitus which is well controlled. Histological examination of the excised body and tail of the pancreas showed that exocrine atrophy, though advanced, was incomplete. It is suggested that in chronic pancreatitis, complete obliteration of the duct system may not be possible because of preexisting duct lesions. This may allow persistence of exocrine pancreatic tissue and lead to the complications of continuing pancreatitis and pseudocyst formation.