title: Silent pancreatic pseudocyst. An unusual cause of extrahepatic biliary obstruction.
abstract: Extrahepatic biliary obstruction due to mechanical obstruction of the common bile duct is a relatively rare complication of pancreatic pseudocyst. When jaundice does occur, clinical or laboratory evidence of associated primary hepatobiliary disease or acute pancreatitis has invariably been present. The patient described had a 3-month history of painless juandice, 40-lb weight loss, pruritus, and hepatomegaly, but no clinical or biochemical evidence of acute or chronic pancreatitis. After initial evaluation, including an abdominal echogram and a transhepatic cholangiogram, carcinoma of the head of the pancreas was diagnosed preoperatively. At laparotomy, a small pancreatic pseudocyst obstructed the terminal portion of the common bile duct. This case illustrates that a pancreatic pseudocyst should be considered in the differential diagnosis of obstructive jaundice, even in the absence of clinical evidence of pancreatitis or pseudocyst formation.
mesh_terms: D000328:Adult; D002758:Cholangiography; D002779:Cholestasis / Q000209:etiology*; D003135:Common Bile Duct; D003937:Diagnosis, Differential; D004906:Erythrocyte Count; D005260:Female; D006801:Humans; D007813:Laparotomy; D007958:Leukocyte Count; D010181:Pancreatic Cyst / Q000150:complications* / Q000175:diagnosis; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D010195:Pancreatitis; D011868:Radioisotopes; D011877:Radionuclide Imaging; D012643:Selenium; D013667:Technetium
chemical_list: D011868:Radioisotopes; D013667:Technetium; D012643:Selenium