Peripancreatic fluid collections: vascular structures masquerading as pseudocysts.
Five patients with splanchnic arterial aneurysms and one patient with a tortuous splenic vessel presented with peripancreatic masses that exhibited an anechoic portion in real-time ultrasonography (US) images; the masses were incorrectly diagnosed as pseudocysts. In two patients a vascular abnormality was suspected, and colour-flow Doppler and pulsed Doppler US were performed; these techniques showed the presence of pseudoaneurysms. In the other four patients the possibility of a pseudoaneurysm was not entertained until further studies had been performed. These results emphasize the need for colour-duplex US evaluation of all peripancreatic fluid collections during the initial US examination to avoid the misinterpretation of an aneurysm or a pseudoaneurysm as a simple or complex fluid collection and to prevent the potential disaster of performing biopsy, surgery or other interventions.
Levin
M F
MF
Department of Diagnostic, Radiology and Nuclear Medicine, University Hospital, University of Western Ontario, London.
Vellet
A D
AD
Bach
D B
DB
Munk
P L
PL
Downey
D B
DB
Bennett
J D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003951:Diagnostic Errors; D006801:Humans; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000175:diagnosis*; D013152:Splanchnic Circulation; D013157:Splenic Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography