Intrasplenic penetration of a pancreatic pseudocyst: Early ultrasonographic detection

Abstract

Splenic complications are rarely encountered in the course of chronic pancreatitis. They may occur either in the form of splenic necrosis, splenic rupture, or formation of intrasplenic pseudocyst(s).l This latter event needs a careful preoperative diagnosis to warrant appropriate surgical management.To our knowledge, all the previously reported occurrences of intrasplenic pseudocyst formation dealt with fluid collection which were well established and detectable at the time the diagnosis was made.We report a case in which it has been possible, by means of serial ultrasonographic examinations, to follow the evolution of the cyst from the very early stages of its onset. CASE REPORTA 54 year-old-white man had chronic pancreatitis. He had had a continous alcohol intake of about 190 g/day for more than 30 years, which he gave up only in 1989.The diagnosis of chronic calcifying pancreatitis was first made in 1975, following a crisis of acute abdominal pain coupled with elevated serum amylase levels up to fivefold greater than the normal upper value. In the following 15 years, in spite of the consumption of alcohol, the patient avoided physicians and major clinical problems. However, in 1990 he started experiencing acute relapses.On September 21, the patient had a new painful attack and was admitted to our hospital. Physical examination showed a mild abdominal

Medical Imaging of the Spleen

“…Although rare (frequency: 1-5%), splenic involvement in pancreatitis can include intrasplenic pseudocyst, abscess, hemorrhage, infarction, splenic rupture and vascular injury (FISHMAN et al 1995). 11.5) without communication with the main pancreatic duct may be misdiagnosed as a splenic tumor (GAIA et al 1992). 11.5) without communication with the main pancreatic duct may be misdiagnosed as a splenic tumor (GAIA et al 1992).…”