Pancreatic pseudocyst in the left hepatic lobe: A report of two cases

Abstract

The ultrasound and computed tomographic imaging features in a rare pancreatic pseudocyst of the liver are described in two patients. The pseudocysts occurred in the left lobe in both cases, one after a traumatic injury and the other after alcoholic pancreatitis. The possible topographical sequences with which pancreatic secretions entered the left hepatic lobe to form a cyst are discussed.

Intrahepatic localization of pancreatic pseudocyst: A case report

“…Most of them are either located in one lobe of the liver or are multiple (3-7), as in our case. The pathophysiology of intrahepatic pancreatic pseudocyst formation can be explained by two mechanisms (6,8): the first mechanism consist of a perforation of the peritoneum along the anterior surface of the pancreas with release of enzymes from a lesser sac collection tracking along the lesser omentum or gastrohepatic ligament toward the left lobe of the liver. The second mechanism consists of spreading of pancreatic fluid from the head of the pancreas into the hepatoduodenal ligament and porta hepatis along the portal vein and its branches.…”

“…The second mechanism consists of spreading of pancreatic fluid from the head of the pancreas into the hepatoduodenal ligament and porta hepatis along the portal vein and its branches. This results in formation of intraparenchymal collections (6,8,9). Subcapsular pseudocysts are located just beneath the liver capsule and are biconvex in shape, while intraparenchymal pseudocysts are located away from the liver capsule and near the porta hepatis branches (5).…”

Intrahepatic Pancreatic Pseudocyst Complicated by Pancreatitis: A Case Report

“…4,[10][11][12][13] The first mechanism is consisted of pancreatic enzyme released following acute pancreatitis into the lesser sac spreading along the lesser omentum and gastrohepatic ligaments. This mechanism explains why IHPPs are frequently observed in the left lobe.…”

Pancreatojejunostomy for Intrahepatic Pseudocyst: A Unique Approach

“…They are often seen in relation to left lobe of liver and often are subcapsular [5,6,8]. A cystic lesion in the liver in presence of acute or chronic pancreatitis should raise the suspicion for intrahepatic pseudocyst.…”

“…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].…”