Atypical pseudocysts of the pancreas: an ultrasonographic evaluation

Ultrasonograms of most pseudocysts have a typical appearance--sharply defined, smooth wall, ovoid, located in the region of the pancreas. However, in reviewing the sonographic appearance of pseudocysts, other ultrasonographic characteristics may occasionally be encountered. Eleven patients with atypical pseudocysts are presented. The demonstration of multiple septations, multiple echoes within a sonolucent mass, and even failure to enhance posteriorly should not exclude the diagnosis of pancreatic pseudocyst in the proper clinical setting. The value of serial scans is also stressed. In this series, it was possible to suggest the diagnosis of infection, hemorrhage, and rupture of pseudocysts by demonstrating cysts with more typical appearances on prior examinations.