Multiple intrahepatic pseudocysts in acute pancreatitis

Abstract

Liver pseudocysts are a very rare complication in acute pancreatitis with only a few cases previously described. The lack of experience and literature on this condition leads to difficulties in the differential diagnosis and management. We report herein a case of acute pancreatitis who developed multiple intrahepatic pseudocysts. After complete imaging evaluation, the diagnosis was still unclear and the patient was operated on. The presence of liver lesions in patients with acute pancreatitis should raise the possibility of intrahepatic pseudocysts.

Figure 1

CT scan showing a hypodense lesion located in the left hepatic lobe of unclear etiology.

Figure 2

Magnetic resonance of the liver and bile duct showing a lesion in segments II and III and a normal common bile duct.

Figure 3

Left lobectomy demon-strating a lesion in segment III.

Figure 4

Cystic lesion in segment II showing the continuity with the lesser omentum and necrotic material from the pseudocyst.

Figure 5

Microscopically the liver pseudocystic lesion is surrounded by a wall formed by macrophages and inflammatory cells (HE, x 20). A: Normal liver tissue; B: Pseudocystic wall; C: Intracystic necrotic debris.