A wayward cyst.
BACKGROUND
Pseudocysts are a common complication of acute and chronic pancreatitis. These are usually located within the pancreas but they can occur at other sites as well, including the mediastinum, neck, pelvis and rarely in the liver as in our case. The diagnosis of intrahepatic pancreatic pseudocyst relies on the demonstration of a high amylase level in the sampled cystic fluid in the absence of infection or neoplasm.


METHODS
A 60-year-old man with a history of chronic pancreatitis presents with a clinical and laboratory picture suggestive of acute exacerbation of his pancreatitis. A computed tomogram (CT) scan of the abdomen revealed a pancreatic pseudocyst and a cystic lesion involving both lobes of the liver. CT diagnostic aspiration of the intrahepatic cyst revealed high amylase level (greater than 20,000 U/L). The cyst was treated with percutaneous drainage with complete resolution of the cyst.


CONCLUSIONS
In the setting of pancreatitis, intrahepatic pancreatic pseudocyst should be considered in the differential diagnosis of cystic lesion of the liver.
Atia
Antwan
A
Department of Internal Medicine, James H Quillen VA Medical Center, East Tennessee State University, Johnson City, Mountain Home, TN, USA. antwan.atia@yahoo.com
Kalra
Sumit
S
Rogers
Mailien
M
Murthy
Ravindra
R
Borthwick
Thomas R
TR
Smalligan
Roger D
RD
D003560:Cysts / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D006801:Humans; D008107:Liver Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D050500:Pancreatitis, Chronic / Q000150:complications; D016896:Treatment Outcome