case_images: PMC9449841_01
case_images: A 73-year-old man with pancreatic ductal adenocarcinoma (PDAC) with PV involvement (pT4N2M0 or Stage III according to AJCC Staging 2017) (A) underwent pancreaticoduodenectomy (PD) and total pancreatectomy with extended lymphadenectomy and segmental portal vein (PV) resection (B).
case_images: fonc-12-888927-g001.jpg
case_images: PMC9449841_01_fonc-12-888927-g001.jpg
case_images: f1
case_images: A 73-year-old man underwent PD and total pancreatectomy with extended lymphadenectomy and segmental portal vein (PV) resection for pancreatic ductal adenocarcinoma (PDAC) with PV involvement (pT4N2M0 or Stage III according to AJCC Staging 2017) ( Figure 1 ).
case_images: (A) The gastrojejunostomosis perforation with peritoneal fluid. PASx400 (B), HEx40 (C), and HEx400 (D) showed Candida spores and budding hyphae invading and destroying adjacent gastric wall and surrounding non-specific inflammation.
case_images: fonc-12-888927-g002.jpg
case_images: PMC9449841_01_fonc-12-888927-g002.jpg
case_images: f2
case_images: A wedge biopsy from the gastrojejunostomosis ulcer margin and peritoneal fluid was taken, and Candida was found in both samples ( Figure 2 ).
case_images: PMC9449841_02
case_images: A 65-year-old man with intraductal papillary mucinous neoplasms (IPMN) of the pancreatic head (B) underwent pancreaticoduodenectomy (PD) with extended lymphadenectomy (A).
case_images: fonc-12-888927-g003.jpg
case_images: PMC9449841_02_fonc-12-888927-g003.jpg
case_images: f3
case_images: A 65-year-old man underwent PD with extended lymphadenectomy for intraductal papillary mucinous neoplasms (IPMN) of the pancreatic head ( Figure 3 ).
case_images: (A) Gastrojejunostomosis stenosis confirmed by gastrointestinal endoscopy. (B) The gastrojejunostomosis was good response after 2 weeks of Fluconazole prophylaxis. PASx400 (C, D), HEx100 (E), and Hex400 (F) showed Candida spores and budding hyphae invading and destroying adjacent gastric wall, and surrounding non-specific inflammation.
case_images: fonc-12-888927-g004.jpg
case_images: PMC9449841_02_fonc-12-888927-g004.jpg
case_images: f4
case_images: After diagnosed with Candida-induced gastrojejunostomosis stenosis by gastrointestinal endoscopy and endoscopic biopsy ( Figure 4 ), fluconazole was indicated for 2 weeks. Blood sample withdrawn afterward showed no evidence of fungal agents and the anastomotic stenosis responded well to treatment ( Figure 4 ).