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Pancreatic pseudocyst involving the spleen
1Department of Surgery, Kaohsiung Medical College Hospital, Taiwan, Republic of China.
The Kaohsiung Journal of Medical Sciences
|October 22, 1998
Summary
Pancreatic pseudocysts, a common pancreatitis complication, can rarely affect the spleen. This case highlights splenic involvement, leading to pain and requiring surgical intervention for recovery.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- Pancreatic pseudocysts are common complications of acute pancreatitis.
- Splenic involvement by pancreatic pseudocysts is an uncommon presentation.
Observation:
- A 40-year-old male with a history of alcohol abuse presented with left upper quadrant (LUQ) abdominal pain.
- MRI revealed cystic lesions in the splenic hilum and pancreatic tail, with associated vascular abnormalities and splenic vein thrombosis on angiography.
- The patient underwent laparotomy due to persistent LUQ pain.
Findings:
- Intraoperative findings confirmed cysts in the pancreatic tail and splenic hilum.
- Aspiration of cystic fluid showed markedly elevated amylase levels (20,000 IU/L), confirming a pancreatic pseudocyst.
- Pathologic examination revealed splenic infarction with cyst formation and a pancreatic pseudocyst.
Implications:
- This case underscores the rare but significant complication of pancreatic pseudocysts involving the spleen.
- Prompt diagnosis and surgical management (splenectomy and distal pancreatectomy) led to successful patient recovery.
- Highlights the importance of considering pseudocyst involvement in patients with LUQ pain and pancreatic disease.