Intrahepatic localization of pancreatic pseudocyst: A case report

Baydar, Behlül; Cantürk, Fatih; Alper, Emrah; Aslan, Fatih; Akpınar, Zehra; Cengız, Onur; Kandemır, Altay; Ünsal, Belkıs

doi:10.4318/tjg.2013.0805

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…They are further characterized by their spatial location in ether the right lobe, left lobe, or involving both lobes. It has been hypothesized that the location of the pancreatic inflammation ( e.g ., head vs tail) is correlated with the tract the fluid takes and eventual location in the liver of the IHPP with several different paths described[4,5,13,15,16,19,33-37]. However, we did not find this to be a statistically significant correlation.…”

Section: Discussioncontrasting

confidence: 66%

“…Prior to the widespread availability of the CT scan, however, a significant workup was often done to identify the etiology of a patient’s presentation and in some cases would include a gastrointestinal transit studies, endoscopy, venogram, arteriogram, or exploratory laparotomy where the lesions were finally identified[10-12]. Endoscopy has been used effectively in several cases, not only including initial diagnosis[13], but also with therapeutic intervention[14,15], as discussed further below.…”

Section: Resultsmentioning

confidence: 99%

“…Although most cases are managed percutaneously or operatively, there is an increasing experience with endoscopic approaches. These have included endoscopic retrograde pancreatography (ERCP) with pancreatic duct stenting, endoscopic transpapillary nasopancreatic drainage, pancreatic duct balloon dilatation, and ERCP-guided aspiration (Table 2)[13-15,24,25]. Bhasin et al[24,25] for example, reviewed 11 patients with atypically located pseudocysts, treated with ERCP and transpapillary nasopancreatic drainage.…”

Section: Resultsmentioning

confidence: 99%

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Intrahepatic pancreatic pseudocyst: A review of the world literature

Demeusy

Hosseini

Sill

et al. 2016

WJH

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AIMTo investigate and summarize the literature regarding the diagnosis and management of intrahepatic pancreatic pseudocysts (IHPP).METHODSA literature search was performed using PubMed (MEDLINE) and Google Scholar databases, followed by a manual review of reference lists to ensure that no articles were missed. All articles, case reports, systematic reviews, letters to editors, and abstracts were analyzed and tabulated. Bivariate analyses were performed, with significance accepted at P < 0.05. Articles included were primarily in the English language, and articles in other languages were reviewed with native speakers or, if none available, were translated with electronic software when possible.RESULTSWe found 41 published articles describing 54 cases since the 1970s, with a fairly steady rate of publication. Patients were predominantly male, with a mean age of 49 years. In 42% of published cases, the IHPP was the only reported pseudocyst, but 58% also had concurrent pseudocysts in other extrapancreatic locations. Average IHPP size was 9.5 cm and they occurred most commonly (48%) in the left hemiliver. Nearly every reported case was managed with an intervention, most with a single intervention, but some required up to three interventions. Percutaneous treatment with either simple aspiration or with an indwelling drain were the most common interventions, frequently performed along with stenting of the pancreatic duct. The size of the IHPP correlated significantly with both the duration of treatment (P = 0.006) and with the number of interventions required (P = 0.031). The duration of therapy also correlated with the initial white blood cell (WBC) count (P = 0.048).CONCLUSIONDiagnosis of IHPP is difficult and often missed. Initial size and WBC are predictive of the treatment required. With appropriate intervention, most patients achieve resolution.

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Section: Discussioncontrasting

confidence: 66%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Intrahepatic pancreatic pseudocyst: A review of the world literature

Demeusy

Hosseini

Sill

et al. 2016

WJH

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“…Some are known to resolve spontaneously [7][8][9] Most cases have been drained percutaneously under radiological guidance [8][9][10][11]. Techniques such as transpapillary pancreatic drainage achieve resolution of the pseudocyst by decompressing the main pancreatic duct [12,13].…”

Section: Discussionmentioning

confidence: 99%

Pancreatojejunostomy for Intrahepatic Pseudocyst: A Unique Approach

Kulkarni¹

2017

Pancreat Disord Ther

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Intrahepatic pseudocyst of pancreas is a very rare entity and a significant diagnostic dilemma with less than 30 cases reported in the world literature. Demonstration of amylase rich fluid and a communication with pancreatic duct system establishes the diagnosis. There are no definite guidelines for the management. Here we describe a patient with alchohol related chronic pancreatitis with pseudocyst in head of pancreas developing intrahepatic dissection of pseudocyst resulting in a large intrahepatic multicystic lesion. The diagnosis was made by CT scan and Ultrasound guided aspiration of intrahepatic cyst contents showing amylase rich fluid. The patient had to be treated for both the pancreatic pain and intrahepatic pseudocyst. The patient underwent lateral pancreaticojejunostomy. The surgery resulted in resolution of intrahepatic pseudocyst by decompressing the main pancreatic duct and also resolved the pain of chronic pancreatitis.The lateral pancreato jejunostomy in this case is unique and not described before to treat intrahepatic pseudocyst.

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“…[8] High amylase and lipase levels obtained by the aspiration of the fluid are the cornerstones for the diagnosis of the pancreatic origin. [8] In our case, the increased levels of amylase and lipase in the aspirated fluid clinched the confirmation of a pancreatic origin.…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic pseudocyst complicating acute pancreatitis: A rare case report

Lyngdoh

Bhattacharya

Phukan

et al. 2016

Int J of Biomed & Adv Res

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Intrahepatic pseudocysts are an extremely rare complication following acute pancreatitis with only a few cases previously described in literature. The paucity of experience and relevant literature on this condition leads to significant challenges in the differential diagnosis and management. We report herein a case of acute pancreatitis with development of left lobe intrahepatic pseudocysts with a dramatic progression prompting management by prompt drainage. The presence of liver lesions in patients with acute pancreatitis should raise the consideration of hepatic pseudocysts in the differential diagnosis, which can lead to a more prompt and appropriate management.

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Intrahepatic localization of pancreatic pseudocyst: A case report

Cited by 10 publications

References 11 publications

Intrahepatic pancreatic pseudocyst: A review of the world literature

Intrahepatic pancreatic pseudocyst: A review of the world literature

Pancreatojejunostomy for Intrahepatic Pseudocyst: A Unique Approach

Intrahepatic pseudocyst complicating acute pancreatitis: A rare case report

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