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

OKUDA, Kunio

doi:10.1016/0270-9139(91)92453-f

Cited by 7 publications

(17 citation statements)

References 2 publications

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“…Most of them are either located in one lobe of the liver or are multiple, as in this case. The pathophysiology of intrahepatic pancreatic pseudocyst formation can be explained by different mechanisms [3,9].…”

Section: Discussionmentioning

confidence: 99%

“…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 the formation of the intraparenchymal collections [3,8,9]. The leakage of the pancreatic collections retroperitoneally posterior to the hepatoduodenal ligament and release of enzymes causes an erosion of the right hepatic parenchyma and leads to subcapsular location.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, only 36 such cases have been described [2]. Spontaneous regression of intrahepatic pseudocysts may occur; therefore, no specific treatment is needed in the majority of cases [3]. Although there are reports that endoscopic procedures such as transpapillary and transmural (transgastric and transduodenal) drainage have been successful in the management of pancreatic pseudocysts, either percutaneous drainage, surgery, or endoscopic sphincterotomy can be performed [4][5][6].…”

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confidence: 99%

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Pancreatic Pseudocysts at Unusual Sites: A Case Report

Gedam¹,

Dubey²,

Sadriwala³

et al. 2018

IJCR

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Pancreatic Pseudocysts at Unusual Sites: A Case Report

Gedam¹,

Dubey²,

Sadriwala³

et al. 2018

IJCR

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“…entery contains ventral anlage of the pancreas and the remnant of the dorsal portion of the ventral mesentery remains after birth as gastro-hepatic and gastro-duodenal ligaments. So, pancreatic sequestered fluids from the head of the pancreas after acute pancreatitis can spread towards porta hepatis, left lobe of the liver [4,6] or even into the right lobe of the liver [7] along with the attachment of hepato-gastric ligament…”

Section: Up To 8 Th Weeks Of Intra-uterine Life Ventral Mes-mentioning

confidence: 99%

Pancreatic abscess within hepato-gastric ligament: case report of an extremely rare disease

Bakshi

2020

BMC Surg

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Background: Pancreatic pseudocyst is a very common benign cystic lesion of the pancreas. It develops in 5-15% of patients with peri-pancreatic fluid collection following acute pancreatitis. Collection usually occurs within the lesser sac of the omentum (near the pancreatic head and body region). But in 20-22% cases, that may be extrapancreatic like in the mediastinum, pleura, in the peritoneal cavity including the pelvis. The pancreatic pseudocyst typically contains brownish fluid with necrotic tissue sludge which may get infected giving rise to infected pseudocyst or pancreatic abscess. The present case is an unusual condition of a young alcoholic subject who was finally diagnosed as a case of a pancreatic abscess within hepato-gastric ligament and was managed with operative intervention. To the best of the author's knowledge, it is the first-ever reported case of a pancreatic abscess within the hepatogastric ligament in the world. Literature was reviewed to explore potential etiopathogenesis and therapeutic strategies of this extremely rare condition. Case presentation: A 38 years old gentleman, chronic alcoholic, having a previous history of acute pancreatitis 3 months back, presented with fever (102 degrees Fahrenheit) and a huge [20 cm (horizontal) X 15 cm (vertical)] severely painful swelling in the epigastric region. The swelling was round-shaped, intra-abdominal, fixed to deeper tissue, tense-cystic, poorly trans-illuminant, non-pulsatile and irreducible. Routine blood tests showed leucocytosis (14,500/mm 3 ) with neutrophilia and elevated plasma pancreatic amylase and lipase levels. USG and MDCT scan of the whole abdomen revealed a thick-walled echogenic cystic swelling of size 18 cm × 12 cm in the epigastric region. USG guided aspiration of the cyst revealed mixed purulent brownish fluid. The cyst fluid was negative for mucin stain and contained high amylase level with low CEA level, suggesting infected pancreatic pseudocyst. An open drainage procedure was considered through an upper midline laparotomy. Aspiration of the pus mixed cyst fluid along with tissue debris was done. Through irrigation of the cyst was done with normal saline. The cyst wall was de-roofed leaving a small part adherent to the inferior surface of the left lobe of the liver. Later the cyst fluid culture showed significant growth of Escherichia coli. He was put on IV antibiotics. The patient was discharged in a stable condition after 5 days. The histopathological examination confirmed pancreatic abscess. Six months after the operation, the patient is doing well, remaining asymptomatic and there is no sign of recurrence. Conclusions: Due to extreme rarity, pancreatic abscess formation within hepato-gastric ligament may be a diagnostic dilemma and requires a high index of suspicion. Surgeons should be aware of this rare clinical entity for prompt management of potential morbidity.

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“…Ascites may develop if there is a communication between the pancreatic duct or a pseudocyst and the peritoneal cavity (2). Infrequently, a pseudocyst may erode into an adjacent organ such as the liver, spleen or stomach, or into other parts of the gastrointestinal tract (3)(4)(5). Erosion of arterial walls may lead to pseudoaneurysms, particularly of the splenic and gastroduodenal arteries, sometimes resulting in massive hemorrhage (2).…”

mentioning

confidence: 99%

Pancreaticoportal Fistula in Association with Antiphospholipid Syndrome Presenting as Ascites and Portal System Thrombosis

Chang

Francoeur

Schweiger

2002

Canadian Journal of Gastroenterology

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Fistulous communication between the pancreas and the portal venous system is extremely rare and is usually a complication of chronic pancreatitis or pancreatic pseudocysts. A patient who presented with abdominal pain and ascites secondary to a pancreaticoportal fistula and portal system thrombosis is described. The diagnosis was made by endoscopic retrograde cholangiopancreatography and confirmed by immediate postprocedure computed tomographic scanning. Laboratory studies identified concomitant antiphospholipid syndrome. The patient responded favourably to supportive medical therapy.

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

Cited by 7 publications

References 2 publications

Pancreatic Pseudocysts at Unusual Sites: A Case Report

Pancreatic Pseudocysts at Unusual Sites: A Case Report

Pancreatic abscess within hepato-gastric ligament: case report of an extremely rare disease

Pancreaticoportal Fistula in Association with Antiphospholipid Syndrome Presenting as Ascites and Portal System Thrombosis

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