Chronic pancreatitis and pseudocysts

Case contributed by Dr Natalie Yang

Presentation

Recurrent abdominal pain.

Patient Data

Age: Adult
Gender: Male

Three phase CT

Modality: CT

Three phase CT demonstrates an atrophic distal pancreas, with two discreet cysts. These are thick walled and have central fluid attenuation. The walls somewhat enhance.

The splenic vein is obliterated, replaced by numerous enlarged collaterals at the splenic hilum and along the greater curvature of the stomach. The spleen and liver appear unremarkable.

This patient went on to have a partial pancreatectomy.

Pathology

Specimen consists of the distal pancreas measuring 11 x 6 x 5 cm. A cross-section of the pancreas shows two separate intact cysts measuring 6 cm and 2.4 cm in greatest dimension that are filled with a pus-like material and necrotic debris.

Case Discussion

Pancreatic pseudocyts can be a challenge to manage and up to half of all pseudocysts do not resolve spontaneously. Additionally, when small and in cases where a firm history of pancreatitis is not present, they can pose a diagnostic challenge, and mimic cystic neoplasms.

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Case Information

rID: 6724
Case created: 11th Aug 2009
Last edited: 19th Dec 2015
Inclusion in quiz mode: Included

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