Case Report
Page Kidney Secondary to Pancreatic Pseudocyst: Definitive Surgical Management with Sustained Normotension: A Case Report with Literature Review
Venugopal H. G.
,
Mukund Mangarai*,
Akshay Patil
Issue:
Volume 10, Issue 2, December 2026
Pages:
67-73
Received:
7 July 2026
Accepted:
20 July 2026
Published:
10 August 2026
Abstract: Background: Page kidney is an uncommon but reversible cause of secondary hypertension due to extrinsic compression of the renal parenchyma, triggering activation of the renin-angiotensin-aldosterone system (RAAS). Pancreatic pseudocysts are a well-recognized complication of acute or chronic pancreatitis and are a rare cause of this phenomenon. Case Presentation: A 21-year-old previously normotensive male presented to the Surgical Gastroenterology (SGE) Out-patient Department (OPD) with dull aching upper abdominal pain for 8 days and progressive abdominal distension for 6 months. At presentation patient had new-onset hypertension (150/100 mmHg) incidentally detected on admission. Contrast-enhanced computed tomography (CECT) of the abdomen revealed chronic calcific pancreatitis with a massive pancreatic tail pseudocyst (~1500 mL) extending into the left perirenal space, near-complete encasement of the left kidney, with a persistent nephrogram on delayed phase imaging, a pathognomonic radiological feature of ‘Page kidney’. The patient underwent laparotomy and Roux-en-Y cysto-jejunostomy in view of persistent abdominal symptoms and showed complete normalization of blood pressure. Patient remained normotensive and asymptomatic at 6 months on follow-up. Discussion: Page kidney secondary to a pancreatic pseudocyst is an exceptionally rare cause of secondary hypertension with very few cases reported in the world literature. All the patients reported in literature were managed conservatively by non-operative management, involving anti-hypertensives and USG (ultrasound) guided pigtail insertion. However, our case describes the management of a page kidney secondary to a pseudocyst by Roux-en-Y cysto-jejunostomy as a definitive therapy, achieving sustained medication-free normotension. Conclusion: Page kidney is a rare, curable cause of secondary hypertension. Early management helps prevent deterioration and salvage of renal function. Surgical drainage procedures are a feasible and durable alternative to conservative management in selected patients, particularly those with recurrent or complex pancreatic pseudocysts.
Abstract: Background: Page kidney is an uncommon but reversible cause of secondary hypertension due to extrinsic compression of the renal parenchyma, triggering activation of the renin-angiotensin-aldosterone system (RAAS). Pancreatic pseudocysts are a well-recognized complication of acute or chronic pancreatitis and are a rare cause of this phenomenon. Case...
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Research Article
Corticosteroid-Induced Candida Albicans Colonization of an Intragastric Balloon: A Case Report and Literature Review
Atteyat Aboelmaged Semeya*,
Walaa Elsaeed,
Mahmoud Ahmed Hassan,
Shahenda Hossam
Issue:
Volume 10, Issue 2, December 2026
Pages:
74-79
Received:
17 July 2026
Accepted:
4 August 2026
Published:
20 August 2026
Abstract: Background: Intragastric balloons (IGBs) are temporary endoscopic devices used for weight management in patients with obesity; while bacterial colonization of IGBs is well recognized, fungal infection remains rarely reported. Case Presentation: We describe a 24-year-old male who developed candidal infection of an intragastric balloon after completing a 14-day course of dexamethasone (8 mg daily), equivalent to approximately 53 mg of prednisone daily, prescribed for presumed allergic rhinitis. Six weeks after balloon placement for obesity management (body mass index [BMI]: 37.2 kg/m²), he presented with epigastric discomfort, nausea, and intermittent vomiting. Upper gastrointestinal endoscopy revealed extensive white-cream fungal plaques covering the balloon surface with mild surrounding mucosal erythema. Microbiological analysis of gastric aspirate confirmed Candida albicans (>10⁵ colony-forming units [CFU]/mL) on culture, with positive potassium hydroxide (KOH) preparation and Periodic Acid-Schiff (PAS) staining. The balloon was removed endoscopically and the patient was treated with fluconazole (400 mg loading dose, then 200 mg daily for 14 days), with complete symptom resolution within five days and eradication confirmed on repeat endoscopy and culture at four weeks. Conclusion: This case illustrates that even short-term corticosteroid therapy can predispose patients with an indwelling IGB to opportunistic fungal colonization. Clinicians should maintain a high index of suspicion for fungal infection in IGB patients who develop new gastrointestinal symptoms during or after immunosuppressive therapy, and early endoscopic evaluation, balloon removal, and antifungal therapy achieve favorable outcomes.
Abstract: Background: Intragastric balloons (IGBs) are temporary endoscopic devices used for weight management in patients with obesity; while bacterial colonization of IGBs is well recognized, fungal infection remains rarely reported. Case Presentation: We describe a 24-year-old male who developed candidal infection of an intragastric balloon after completi...
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