Pancreatic pseudocyst with splenic vein compression

Case contributed by Dr. Cherepanov Oleg

Presentation

A month ago there was a severe exacerbation of chronic pancreatitis. Persistent abdominal pain

Patient Data

Age: 35 years
Gender: Male

The pancreas is atrophic, its outlines are shallow, clear. The structure is inhomogeneous due to calcification along the main duct.

From the tail of the pancreas, a cystic formation with a capsule up to 4 mm in thickness occurs, the contents of the liquid density + 7HU, irregularly shaped, stretched along the anterior-upper edge of the spleen to the left sub-diaphragmatic space, the capsule accumulates contrast material.

Cystic formation compresses the splenic vein in the area of the gates, Visualized enlarged and convoluted collateral veins along the stomach and in a large omentum.

The walls of the stomach and large intestine with the sign of the "target-water" due to the swelling of the submucosal layer.

The spleen is enlarged in size, the heterogeneous structure is due to a two-chamber cyst.

Case Discussion

The last exacerbation of pancreatitis was caused by the formation of large pseudocysts. Subsequently, venous outflow of the spleen was disturbed. Collateral blood flow through the veins of the stomach and peritoneum formed. Edema in the gastric and colonic walls reflects venous congestion.

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Case information

rID: 58773
Published: 6th Mar 2018
Last edited: 29th May 2019
Inclusion in quiz mode: Included
Institution: MIBS PERM

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