Pancreatitis complicated by pancreatic pseudocyst

Case contributed by Ahmad Elbelgihy
Diagnosis certain

Presentation

Abdominal and back pain. Elevated CRP. History of gall stones.

Patient Data

Age: 60 years old
Gender: Male

Swollen edematous pancreas with peripancreatic extensive fat stranding consistent with acute interstitial (edematous) pancreatitis. 

The CBD is prominent with no dense stones seen inside. 

Minimal bilateral pleural effusion with posterior basal subsegmental atelectasis.

3 mth later vague abdo pain

ultrasound

An irregular encysted fluid collection is seen at the epigastric region adjacent to stomach suspected to be peri-pancreatic fluid collection. It shows turbid fluid contents. In view of the patient’s history of pancreatitis 3 months ago, pancreatic pseudocyst should be considered. Further evaluation by contrast-enhanced CT study of the abdomen was advised.

Calcular gall bladder with no peri-cholecystic fluid collection detected.

Post contrast CT study

ct

A well defined encapsulated fluid collection is seen related to the superior aspect of the body of pancreas which is partially encased by the collection. No calcifications inside. No obvious solid components. The pancreas shows homogeneous texture with almost clear related fat planes. Findings are impressive of pancreatic pseudocyst.

Case Discussion

Pancreatic pseudocysts are common sequelae of acute pancreatitis or chronic pancreatitis, and the most common cystic lesion of the pancreas.

Case courtesy of Dr Yaser Zakaria and Dr Mohammad Senousy.

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