| Autor: |
Di Paolo, Marcello, Di Gaeta, Alessandro, Indino, Elena Lucia, Mordenti, Michela, Palange, Paolo |
| Zdroj: |
Respiratory Medicine Case Reports; 2019, Vol. 29, pN.PAG-N.PAG, 1p |
| Abstrakt: |
Pancreatic cystosis (PC) is an uncommon manifestation of pancreas involvement in cystic fibrosis (CF), characterized by the presence of multiple macrocysts partially or completely replacing pancreas. Only few reports are available from literature and management (surgery vs follow up) is commonly based on the presence of symptoms or complications due to local mass effect, although evidence-based recommendations are still not available. We here report the case of a young adult CF patient with PC, in which cardiopulmonary exercise testing (CPET) provided important information to be integrated to the radiological finding of inferior vena cava compression by the multicystic pancreas complex. Through the analysis of oxygen kinetic cardiodynamic phase pattern, CPET may be helpful to safely exclude significant mass effects on blood venous return and to improve the decision-making process on whether to consider surgery or not in patients with PC. • Pancreatic cystosis is a rare manifestation in cystic fibrosis, with no evidence-based recommendations on proper management available. • Clinical management (surgery vs monitoring) is usually driven by the presence of symptomatic complications due to mass-effect. • Cardiopulmonary exercise testing may help assess the functional consequences of asymptomatic inferior vena cava compression by pancreatic cystosis. • Analysis of oxygen kinetics during moderate-intensity exercise safely provides anon-invasive estimate of the integrity of venous return to the right atrium. • Referral to highly specialized centers in exercise physiology may help clinicians in difficult decision-making processes. [ABSTRACT FROM AUTHOR] |
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