Computed tomography of pancreatic pseudocysts of the duodenum

The findings of computed tomography (CT) in seven patients with pancreatic pseudocysts involving the duodenum are reported. Specific CT characteristics of duodenal wall involvement by the pseudocysts are tubular configuration of the pseudocyst, extending along the wall and conforming to the course of the duodenum (seven of seven), and abrupt flattening of the otherwise tubular or spherical pseudocyst at the border of the duodenal lumen (five of seven). The second part of the duodenum was involved in all cases; in some cases the first part of the duodenum was also involved (two of seven), and in others the pseudocyst extended to the third part of the duodenum (two of seven). All patients had other CT evidence of pancreatitis in addition to duodenal pseudocysts. CT findings are compared to other imaging methods and clinical and surgical findings. Patients with duodenal pseudocysts should be watched carefully for signs and symptoms of gastric outlet obstruction, since this was a prominent clinical problem in six of seven patients, and gastric outlet obstruction complicating suspected pancreatitis should alert to the possibility of duodenal pseudocyst.