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Fibrocalculous pancreatic diabetes with hemorrhagic pericardial effusion in a female—a rare case report

  • Vineeta SinghEmail author
  • Mohit Singh Tandon
Case Report
  • 18 Downloads

Abstract

Fibrocalculous pancreatic diabetes (FCPD) is a unique form of diabetes due to non-alcoholic chronic pancreatitis peculiar to tropical countries. The hallmark features are younger age of onset pain abdomen and presence of pancreatic calculi. Though etiology remains unclear but on long-term follow-up, patient may develop microvascular and macrovascular complication. Chances of progression to malignancy are also high which carries poor prognosis. We present a case of a 36-year-old female presenting with recurrent abdominal pain, diabetes and chronic calcific pancreatitis. She was diagnosed to have FCPD based on her findings. She was managed with insulin, pancreatic enzyme supplementation and analgesics for pain relief. Due to her intractable pain poorly responding to medical management, she underwent Roux-en-Y pancreaticojejunostomy but later developed massive pericardial effusion hemorrhagic in nature with pleural effusion and ascitis. Analysis showed high possibility of adenocarcinoma though the primary focus could not be confirmed as the patient developed sepsis and unfortunately succumbed to her illness. Though FCPD is a rare entity, it is important to rule out chronic calcific pancreatitis as underlying etiology in all patients of diabetes presenting with recurrent pain abdomen and also to periodically screen FCPD patients for pancreatic malignancy. This helps to prevent progression to complications by an early medical intervention. Surgical intervention may be considered an option in case of failure of medical management, though data of its usefulness is very rare.

Keywords

Fibrocalculous pancreatic diabetes Hemorrhagic pericardial effusion Roux-en-Y pancreatojejunostomy Adenocarcinoma 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the participant involved.

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Copyright information

© Research Society for Study of Diabetes in India 2018

Authors and Affiliations

  1. 1.Department of MedicineShrimad Rajchandra HospitalDharampur, ValsadIndia

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