A case report of disconnected pancreatic duct syndrome: an underrecognized complication of acute necrotizing pancreatitis.

Abstract

Disconnected pancreatic duct syndrome (DPDS) is a rare condition characterized by a disruption of the pancreatic duct, separating viable pancreatic tissue from the gastrointestinal tract. It often follows acute or chronic pancreatitis, abdominal trauma, or pancreatic surgery, leading to ductal necrosis or disintegration. DPDS presents significant diagnostic and management challenges, especially in cases with delayed onset. The authors report a complex case of recurrent pancreatic fluid collections after necrotizing pancreatitis, highlighting the potential for delayed DPDS manifestation. Advanced imaging techniques, including endoscopic ultrasonography, contrast-enhanced CT, and MRCP, were used for diagnosis. Due to failure of conservative treatment, a distal pancreatectomy was performed, resolving the issue and preventing complications such as infection, sepsis, or pancreatic fistula. This case underscores the importance of early recognition of DPDS on imaging, facilitating timely treatment and reducing the risk of long-term complications.