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Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 12, Issue 2, pp 135–137 | Cite as

Right intrahepatic pseudocyst following acute pancreatitis: an unusual location after acute pancreatitis

  • Silvio Balzan
  • Reza Kianmanesh
  • Olivier Farges
  • Alain Sauvanet
  • Dermot O’Toole
  • Philippe Levy
  • Philippe Ruszniewski
  • Satoshi Ogata
  • Jacques Belghiti
Case reports of interest

Abstract

The location of a pseudocyst (PC) in the liver is an exceptional event, and intrahepatic PCs are mainly located in the left lobe. We report here a case of right intrahepatic PC following acute pancreatitis associated with cystic (aberrant pancreatic) dystrophy of the duodenal wall (CDDW) and chronic pancreatitis. Morphological assessment (ultrasound, computed tomography [CT] scan, and cholangio-magnetic resonance imaging [MRI]) revealed a 10-cm right intrahepatic collection and rupture of the main pancreatic duct. Percutaneous puncture permitted us to detect a high level of amylase in the collection, confirming the diagnosis of intrahepatic PC. Surgical drainage concomitant with pancreatico-duodenectomy for the treatment of CDDW resulted in disappearance of the collection. The mechanism involved in this patient was rupture of the pancreatic duct in the retroperitoneal cavity and erosion reaching the right hepatic parenchyma. Although intrahepatic PCs are rare, the diagnosis of intrahepatic PC complicating acute pancreatitis can be confirmed by a high level of amylase in the collection. Asymptomatic intrahepatic PCs can be treated conservatively, and symptomatic intrahepatic PCs can be managed either transcutaneously or surgically.

Key words

Intrahepatic Pseudocyst Acute pancreatitis 

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Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Silvio Balzan
    • 1
  • Reza Kianmanesh
    • 1
  • Olivier Farges
    • 1
  • Alain Sauvanet
    • 1
  • Dermot O’Toole
    • 2
  • Philippe Levy
    • 2
  • Philippe Ruszniewski
    • 2
  • Satoshi Ogata
    • 1
  • Jacques Belghiti
    • 1
  1. 1.Department of Hepato-Pancreatico-Biliary SurgeryHospital BeaujonClichyFrance
  2. 2.Department of GastroenterologyHospital BeaujonClichyFrance

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