Pancreatic pseudocyst located in the liver

Les, Íñigo; Córdoba, Juan; Vargas, Victoria Ayala; Guarner, Luisa; Boyé, Rosa; Pineda, Víctor

doi:10.4321/s1130-01082006000800007

Cited by 14 publications

(5 citation statements)

References 7 publications

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“…Although IHPP lesions may be clinically suspected in a patient based on the presentation and radiological imaging, definitive diagnosis was rarely made until analysis of the cystic fluid was performed demonstrating a high amylase content[6,7,17,20,21]. …”

Section: Resultsmentioning

confidence: 99%

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: Resultsmentioning

confidence: 99%

Intrahepatic pancreatic pseudocyst: A review of the world literature

Demeusy

Hosseini

Sill

et al. 2016

WJH

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“…Pancreatic pseudocysts can present various complications, some more common such as infection, rupture, and gastrointestinal obstruction, to the slightly rarer. Hepatic pseudocysts are a recognized but rare phenomenon described within published case reports 7 8 9 10 11 12 . In one report of a patient presenting with a large liver cystic lesion in association with a pancreatic tail pseudocyst, the authors proposed several potential mechanisms for development of hepatic pseudocysts, including through direct invasion or possibly presence of heterotopic pancreatic tissue within the liver.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic pseudocyst-portal vein fistula with refractory hepatic pseudocyst: Two cases treated with EUS cyst-gastrostomy and review of the literature

et al. 2019

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Background and study aims Pseudocysts are the most common pancreatic cystic lesions and they usually develop in association with pancreatitis of at least 4 weeks’ duration. Extra-pancreatic pseudocysts, although reported, are relatively uncommon. Secondary liver pseudocysts are recognized within the literature, and most patients described have required percutaneous or surgical drainage due to infection or symptoms. The mechanism of hepatic pseudocyst formation is not entirely clear but it is postulated that this phenomenon may occur through pseudocyst-portal vein fistulization. We describe two cases of patients presenting with pancreatic pseudocysts invading the portal venous system with embolization of pancreatic fluid to the liver and subsequent hepatic pseudocyst formation. Interestingly, liver pseudocyst resolution was incomplete with antibiotics and percutaneous drainage alone, and only occurred following endoscopic ultrasonography-guided pancreatic cyst-gastrostomy and metal stent insertion. We have reviewed the current literature on the diagnosis and management of pseudocyst-portal vein fistula formation and we believe that our cases represent the first published within the literature to describe this treatment approach.

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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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Pancreatic pseudocyst located in the liver

Cited by 14 publications

References 7 publications

Intrahepatic pancreatic pseudocyst: A review of the world literature

Intrahepatic pancreatic pseudocyst: A review of the world literature

Pancreatic pseudocyst-portal vein fistula with refractory hepatic pseudocyst: Two cases treated with EUS cyst-gastrostomy and review of the literature

Pancreatojejunostomy for Intrahepatic Pseudocyst: A Unique Approach

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