Shrestha G, Rajbhandari S, Karki B, Bashya B, Ghimire B.
Intrahepatic pancreatic pseudocyst (wayward cyst): A rare presentation of traumatic pancreatitis.
Int J Surg Case Rep 2024;
114:109125. [PMID:
38100928 PMCID:
PMC10762353 DOI:
10.1016/j.ijscr.2023.109125]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION
Cystic lesions in the liver are commonly encountered space-occupying lesions having various etiologies such as simple cysts, malignancies, hydatid cysts, and pancreatic pseudocysts.
CASE PRESENTATION
An eight-year-old girl initially presented with acute abdominal pain, fever, and a cystic lesion in the upper abdomen. Surgical intervention was performed based on an initial diagnosis of an inflammatory cyst. Later, she developed pleural effusion. Further investigations, unveiled a cystic mass arising from the head of the pancreas, and a pancreatico-pleural fistula. Retrospective analysis revealed a history of trauma that started her illness course. Conservative management involving intercostal tube drainage and octreotide infusion resulted in a favorable outcome.
DISCUSSION
Pancreatic pseudocyst is typically results from pancreatitis or trauma but in rare cases, they can have extended to unusual locations such as the liver. This case highlights the varied presentations and complex interplay of symptoms associated with intrahepatic pseudocysts. The initial oversight of trauma in the patient's history underscore the importance of thorough history-taking for an accurate diagnosis. The complexity of this case emphasize the necessity of a multidisciplinary approach in managing such atypical presentations.
CONCLUSION
Intrahepatic pseudocysts, especially those resulting from post-traumatic pancreatic pseudocyst, are uncommon and are not typically included in the differential diagnosis of liver lesions. This case highlights the significance of identifying unusual presentation and thoroughly investigating the patient's medical history to make an accurate diagnosis. A multidisciplinary approach is essential for effective patient management in these complex cases.
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