Surgery for pancreatic tumors during pregnancy: A case report and review of the literature

Seven cases of surgery of pancreatic tumors during pregnancy have been reported in the literature. Six of the cases resulted in live term births. The patient discussed herein, a 37-year-old para 2-0-0-2 white female, had surgery for the removal of a pancreatic mass at 20 2/7 weeks' gestation. No intraoperative complications occurred, and both mother and fetus appeared to have done well. The postoperative course was complicated by pseudomembranous enterocolitis caused by C. difficile, which was treated with antibiotics. Despite treatment, diarrhea continued, and the patient was readmitted to the hospital for hydration and further antibiotics at 27 weeks. Three days after admission, the fetus was noted to have poor biophysical testing and a caesarean delivery was performed. The infant was found to have a large intracerebral hemorrhage, which most likely occurred antenatally, and life support was discontinued shortly after birth. We conclude from this that surgery for a pancreatic mass in pregnancy should be approached cautiously, and the risk to both the mother and fetus should be considered.