Management of asparaginase induced hemorrhagic pancreatitis complicated by pseudocyst

Asparaginase induced hemorrhagic pancreatitis is a rare but serious development occurring in less than 0.5% of patients treated with this drug. Severe pancreatitis with progressive abdominal distention, toxemia, hypotension and respiratory insufficiency occurred in an 18‐year‐old patient with acute lymphoblastic leukemia following treatment with asparaginase. There was a dramatic response to high flow peritoneal lavage with rapid recovery within 24 hours from a moribund state. The subsequent development of a pseudocyst, with progressive increase in size and development of obstructive symptoms, required surgical decompression. Transgastric cystogastrostomy was successfully carried out. Cancer 43:718–722, 1979.