Kim Hee Joon, Jun Chung Hwan, Park Chang Hwan, Cho Chol Kyoon
Department of Surgery and Division of Gastroenterology, Chonnam National University Medical School, Gwangju, Korea.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Korean J Gastroenterol. 2017 Oct 25;70(4):202-207. doi: 10.4166/kjg.2017.70.4.202.
Pancreatic pseudocyst is a common complication of acute pancreatitis. Pseudocysts are commonly observed in the lesser sac and retroperitoneum; they are rarely seen in the liver. Herein, we report a case of intrahepatic pseudocyst, complicated by asymptomatic groove pancreatitis, that has successfully been treated with hepatic resection. A 70-year-old woman was referred to our hospital with severe upper abdominal pain. Abdominal computed tomography scan showed 11x10 cm sized cystic lesion in the left lateral section of the liver. Appearance of the pancreas was relatively normal. Endoscopic aspiration revealed a high level of amylase in the cystic fluid. After endoscopy, signs of peritonitis were observed; then, a left hemihepatectomy was performed. Pathologic examination revealed an intrahepatic pancreatic pseudocyst. The presence of intrahepatic cystic lesion in patients with suspected pancreatitis should raise the suspicion of intrahepatic pseudocyst. Intrahepatic pancreatic pseudocysts may be the only clinical manifestation even without an episode of acute pancreatitis.
胰腺假性囊肿是急性胰腺炎的常见并发症。假性囊肿常见于小网膜囊和腹膜后;很少见于肝脏。在此,我们报告一例肝内假性囊肿合并无症状性沟部胰腺炎,经肝切除成功治疗的病例。一名70岁女性因严重上腹痛转诊至我院。腹部计算机断层扫描显示肝脏左外侧段有一个11×10 cm大小的囊性病变。胰腺外观相对正常。内镜抽吸显示囊液中淀粉酶水平较高。内镜检查后,观察到腹膜炎体征;随后,进行了左半肝切除术。病理检查显示为肝内胰腺假性囊肿。疑似胰腺炎患者出现肝内囊性病变应怀疑肝内假性囊肿。即使没有急性胰腺炎发作,肝内胰腺假性囊肿也可能是唯一的临床表现。