Pancreatic Pseudocyst Eroding Into the Splenoportal Venous Confluence and Mimicking an Arterial Aneurysm

Radiology Case Reports 01/2009; 4(1(2009)). DOI: 10.2484/rcr.v4i1.234


We report the case of a 62-year-old man with chronic pancreatitis who presented with
increasing abdominal pain. Sonography, magnetic resonance imaging, contrast-enhanced
computed tomography, and ultimately catheter angiography demonstrated a pancreatic
pseudocyst that had eroded into the splenoportal venous confluence, mimicking an
arterial aneurysm. The diagnostic was confirmed at the time of surgical treatment. This
case demonstrates the use of imaging to diagnose complications of pancreatitis, and the difficulty
of distinguishing an eroding pseudocyst from an arterial aneurysm.

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    • "Imaging has been the cornerstone in the management and follow up of patients with pancreatitis [5-7]. It is frequently used to evaluate the severity of the disease and to look for its related complications. "
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    ABSTRACT: Rupture into the portal vein is a rare complication of a pancreatic pseudocyst. Only 15 cases of such an incidence have been described in the literature. Only one of these was diagnosed with magnetic resonance imaging (MRI), the rest being diagnosed using other invasive diagnostic modalities or at surgery. We report a case of this rare complication diagnosed on MRI and also describe the demonstration of residual lysed thrombus within the portal vein as a new feature on MRI which supports this diagnosis. The presence of liver necrosis present in our case is a probable effect of this complication not described in the literature before. Early diagnosis of this potentially lethal complication can help in the proper management of these patients.
    Full-text · Article · Apr 2014 · Annals of Gastroenterology