Summary
An intrasplenic psudocyst associated with the acute relapsing phase of chronic pancreatitis in a 51-year-old woman is reported, with a review of the Japanese literature. The patient was admitted with a complaint of left lateral and back pain. Abdominal US and CT revealed communicating cysts at the pancreatic tail and the subcapsule of the spleen. A repeat US and CT 1 month after admission demonstrated enlargement of the cyst at the pancreatic tail. ERCP revealed a dilated main pancreatic duct without any definite evidence of stenosis, and direct communication with the cyst at the pancreatic tail. Percutaneous cystography revealed that the subcapsular cyst of the spleen, the cyst of the pancreatic tail, and the main pancreatic duct communicated with each other. The cyst contained serous fluid with an amylase content of 57,500 IU/I. Distal pancreatectomy and splenectomy was performed. Histologically, there was a nonepithelial lining on the inner surface of the cysts at the pancreatic tail and the subcapsule of the spleen. Severe chronic inflammatory changes were present in the resected tail of the pancreas. Timely surgical treatment is advocated to reduce the mortality and morbidity associated with complications of intrasplenic pseudocysts.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Renner IG, Savage WT, Pantoja JL, et al. Death due to acute pancreatitis. Dig Dis Sci 1985;30:1005–1018.
Buggy BP, Nostrant TT. Lethal pancreatitis. Am J Gastroenterol 1983;78:810–814.
Roton, Mieng, Auburtin. Observation d’un kyste pancreatique de la rate. Rev Med Francaise d’Extreme Orient 1941;19:139–140.
Nagashima M, Takao Y, Wakabayashi N, et al. A case of splenic cyst combined with chronic pancreatitis and perisplenitis. Med J Yamaguchi Univ 1974;23:115–119. (in Japanese)
Okuda K, Taguchi T, Ishihara K, et al. Intrasplenic pseudocyst of the pancreas. J Clin Gastroenterol 1981;3:37–41.
Takahashi H, Nakaji M, Kitagishi H, et al. A case of an infected intrasplenic pancreatic pseudocyst with a review of 22 cases in the Japanese literature. Med J Kinki Univ 1987;12:525–532. (in Japanese)
Nakata S, Kurokawa Y, Kamiya J, et al. A case of pancreatic pseudocysts which penetrated into the liver and formed A-P shunt. Biliary Tract and Pancreas 1987;8:109–114. (in Japanese)
Yano T, Kaneda M, Yamamoto T, et al. Pancreatic pseudocyst involving the spleen. Gastroenterol Jpn 1988;23:73–77.
Fukae S, Kawazoe E, Nomura Y, et al. A case of intrasplenic pseudocyst associated with pancreatitis. J Med Imagings 1990;10:226–229. (in Japanese)
Nakashima K, Sakaguchi H, Minami Y, et al. A case of cancer of the pancreas head with splenic cyst communicating with the main pancreatic duct due to obstructive pancreatitis. Biliary Tract and Pancreas 1991;12:803–807. (in Japanese)
Nakai H, Harafuji I, Orita Y, et al. A case of chronic pancreatitis involving the spleen. J Jpn Soc Clin Surg 1991;52:1374–1378. (in Japanese)
Bolivar JC, Lempke RE. Pancreatic pseudocyst of the spleen. Ann Surg 1974;179:73–78.
Warshaw AL, Chesney TM, Evans GW, et al. Intrasplenic dissection by pancreatic psudocyst. N Engl J Med 1972;287:72–74.
Slater G, Burrows L, Rudick J. Pseudocyst of the pancreas involving the spleen. Ann Surg1982;48:324–325.
Sitzmann JV, Imbembo AI. Splenic complications of a pancreatic pseudocyst. Am J Surg 1984;147:191–196.
Bradley EL, Clements JL, Gonzalez AC. The natural history of pancreatic pseudocysts—a unified concept of management. Am J Surg 1979;137:135–141.
Gonzalez AC, Bradley EL, Clements JL. Pseudocyst formation in acute pancreatitis: Ultrasonographic evaluation of 99 cases. Am J Roentgenol 1976;127:315–317.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ueda, N., Takahashi, N., Yamasaki, H. et al. Intrasplenic pancreatic pseudocyst: A case report. Gastroenterol Jpn 27, 675–682 (1992). https://doi.org/10.1007/BF02774985
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02774985