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Urinoma masquerading as pancreatic pseudocyst
J A Sorgman1, E Langevin, P A Banks
1Department of Radiology, St. Elizabeth's Hospital of Boston, Tufts University School of Medicine, MA 02135.
Summary
A patient with recurrent pancreatitis developed a cystic mass mimicking a pancreatic pseudocyst after celiac plexus injections. Delayed CT scans confirmed it was a urinoma, a rare finding in this context.
Area of Science:
- Gastroenterology
- Urology
- Radiology
Background:
- Recurrent pancreatitis can cause significant pain requiring interventions like celiac plexus injections.
- Celiac plexus injections are used for pain management in pancreatic conditions.
- Pancreatic pseudocysts are common complications of pancreatitis.
Observation:
- A patient with recurrent pancreatitis, post-celiac plexus injections, developed a cystic mass near the pancreas.
- The mass was initially suspected to be a pancreatic pseudocyst due to its location and appearance.
- This presentation is unusual following such interventions.
Findings:
- The cystic mass was diagnosed as a urinoma, not a pancreatic pseudocyst.
- Computed tomography (CT) scan with intravenous contrast and delayed imaging was crucial for diagnosis.
- The CT findings revealed contrast leakage into the cystic structure, indicative of a urinoma.
Implications:
- This case highlights the importance of considering urinoma in the differential diagnosis of cystic pancreatic masses.
- Radiological distinction between pancreatic pseudocyst and urinoma is critical for appropriate patient management.
- This is the first reported instance of a urinoma presenting as a pancreatic pseudocyst after celiac plexus injections.