[Computed tomography of intrahepatic pancreatic pseudocysts]

Intrahepatic pseudocyst complicating pancreatitis is a rare event. The goals of this paper are to report the computed tomographic (CT) features of intrahepatic pseudocyst and to analyze the role of percutaneous puncture and percutaneous drainage in the diagnosis and treatment of intrahepatic pseudocyst.

Three cases of intrahepatic pseudocyst studied by CT were retrospectively reviewed. Percutaneous puncture of the intrahepatic pseudocyst was performed in two cases, and was subsequently followed by percutaneous drainage of the intrahepatic pseudocyst in one case.

In the three cases, intrahepatic pseudocysts appeared like multiple, hypoattenuating, homogeneous intrahepatic fluid collections, associated with intrahepatic bile duct dilatation in one case. In the two cases in which it was performed, percutaneous puncture of the pseudocyst revealed an elevated amylase level, thus confirming the diagnosis. In one case, percutaneous puncture revealed superinfection, thus indicating percutaneous drainage of the pseudocyst.

The diagnosis of intrahepatic pseudocyst should be suggested in the presence of pancreatic lesions and a single or multiple intrahepatic fluid collections visible on CT. CT allows percutaneous puncture of the pseudocyst to be done, thus confirming the diagnosis and indicating subsequent performance of percutaneous drainage in complicated cases.