Perirenal pancreatic pseudocysts: diagnostic management

Area of Science:

• Gastroenterology
• Nephrology
• Diagnostic Imaging

Background:

• Pancreatic pseudocysts can present atypically, mimicking intrinsic renal pathology.
• Distinguishing pseudocysts from renal masses is critical for appropriate patient management.

Observation:

• Three cases are presented where pancreatic pseudocysts involved the kidney.
• Initial clinical presentation and imaging suggested primary renal disease.

Findings:

• Sonographically guided cyst aspiration with amylase level determination in cyst fluid confirmed the diagnosis in all cases.
• Laboratory studies excluded infection, a known pseudocyst complication.
• This diagnostic approach guided timely and appropriate surgical intervention.

Implications:

• Patients with renal region fluid collections may have pancreatic pseudocysts, even without a history of pancreatitis or trauma.
• Fine-needle aspiration is a safe and effective diagnostic tool.
• Amylase testing of cyst fluid, alongside bacteriologic and cytologic evaluation, is essential, even with normal serum amylase levels.