Pancreatic Pseudocyst of Gastrohepatic Ligament: A Case Report and Review of Management

Sunder Goyal; Rajesh Raju; Sidhartha Yadav

doi:10.6092/1590-8577/806

Sunder Goyal Department of Surgery, Muzaffarnagar Medical College. Muzaffarnagar, UP, India
Rajesh Raju Department of Surgery, MM Institute of Medical Sciences and Research. Mullana, Ambala, India
Sidhartha Yadav Department of Surgery, MM Institute of Medical Sciences and Research. Mullana, Ambala, India

DOI: https://doi.org/10.6092/1590-8577/806

Keywords: Pancreatic Pseudocyst

Abstract

Context Pancreatic pseudocyst of gastrohepatic or hepatoduodenal ligament and of liver is rare entity. Probably, pancreatic pseudocyst ascends via these ligaments to liver due to complex attachment of peritoneum. Very few cases have been reported in literature. Case report Hereby, we report a case of pancreatic pseudocyst of hepatoduodenal ligament in patient who presented with pain and lump in epigastric region. Conclusion This is an extrapancreatic extension of pancreatic pseudocyst and a high suspicion of this cyst (gastrohepatic ligament cyst) should be kept in mind as differential diagnosis of epigastric mass.

Image: Excised pancreatic pseudocyst of gastrohepatic ligament.

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Author Biographies

Sunder Goyal, Department of Surgery, Muzaffarnagar Medical College. Muzaffarnagar, UP, India

Professor of Surgery
Head of minima invasive & endourology unit

Rajesh Raju, Department of Surgery, MM Institute of Medical Sciences and Research. Mullana, Ambala, India

Surgery, Assistant professor

Sidhartha Yadav, Department of Surgery, MM Institute of Medical Sciences and Research. Mullana, Ambala, India

Surgery, Junior Resident

References

Hamm B, Franzen N. Atypically located pancreatic pseudocysts in the liver, spleen, stomach wall and mediastinum: their CT diagnosis. Rofo 1993; 159:522-7.

Chahal P, Baron TH, Topazian MD, Levy MJ. EUS-guided diagnosis and successful endoscopic transpapillary management of an intrahepatic pancreatic pseudocyst masquerading as a metastatic pancreatic adenocarcinoma (with videos). Gastrointest Endosc 2009; 70:393-6.

Trikes T, Sandrasegaran K, Patil AA, Hollar MA, Tejada JG, Tann Mark et al. Peritoneal and Retroparitoneal Anatomy and its Relevance for Cross-Sectional Imaging. Radiographics 2012; 32: 437-451.

Shibasaki M, Bandai Y, Ukai T. Pancreatic pseudocyst extending into the liver via the hepatoduodenal ligament: a case report. Hepatogastroenterology 2002; 49:1719-21.

Okuda K, Sugita S, Tsukada E, Sakuma Y, Ohkubo K. Pancreatic pseudocyst in the left hepatic lobe: a report of two cases. Hepatology 1991; 13:359-63.

Panackel C, Korah AT, Krishnadas D, Vinayakumar KR. Pancreatic Pseudocyst Presenting as Dysphasia: A Case Report. Saudi J Gastroenterol. 2008 ; 14:28-30

Dong P, Wang B, Sun Y. Tuberculous abscess in hepatoduodenal ligament: Evaluation with contrast enhanced computed tomography W J Gastroenterol 2008; 14: 2284-2287.

Mofredj A, Cadranel JF, Dautreaux M, Kazerouni F, Hadj-Nacer K, Deplaix P, et al. Pancreatic pseudocyst located in the liver: a case report and literature review. J Clin Gastroenterol 2000; 30:81-3.

Wang SJ, Chen JJ, Changchien CS, Chiou SS, Tai DI, Lee CM, et al. Sequential invasions of pancreatic pseudocysts in pancreatic tail, hepatic left lobe, caudate lobe, and spleen. Pancreas 1993; 8:133-6.

Aiza I, Barkin JS, Casillas VJ, Molina EG. Pancreatic pseudocysts involving both hepatic lobes. Am J Gastroenterol 1993; 88:1450-2.

Ryu JK, Woo SM, Hwang JH, Jeong JB, Yoon YB, Park IA, et al. Cyst fluid analysis for the differential diagnosis of pancreatic cysts. Diagn Cytopathol 2004; 31:100-5.

Balzan S, Kianmanesh R, Farges O, Sauvanet A, O'toole D, Levy P, et al. Right intrahepatic pseudocyst following acute pancreatitis: an unusual location after acute pancreatitis. J Hepatobiliary Pancreat Surg 2005; 12:135-7.

Atia A, Kalra S, Rogers M, Murthy R, Borthwick TR, Smalligan RD. A wayward cyst. JOP. J Pancreas (Online) 2009; 10:421-4.

14.Varadarajulu S, Noone TC, Tutuian R, Hawes RH, Cotton PB. Predictors of outcome in pancreatic duct disruption managed by endoscopic transpapillary stent placement. Gastrointest Endosc 2005; 61:568-75

Musharaf H AEI, Auriefi M AAI. Traumatic pancreatic pseudocyst. S J Gastroenterology 1996; 2: 160-163

Andren-Sandberg A, Ansorge C, Eiriksson K, Glomsaker T, Malickas A, Treatment of pacreatic pseudocysts. Scand J Surg 2005; 94: 165-75

D'Egidio A, Schein M. Pancreatic Pseudocyst: A proposed classification and its management implications. Br J Surg1991; 78: 981-84.

Grace PA, Williamson RCN. Modem management of pancreatic pseudocysts. Br J Surg1993; 80: 573-81.

Yeo JC, Bastidas JA, Lynch Nyhan A, Fishman KE, Zinner MJ, Cameron JL. The natural history of pancreatic pseudo¬cyst documented by computed tomography. Surg GynecolObstet1990:170:411-16.

Shilyansky J, Sena LM, Kreller M, Chait P, Babyn PS, Filler RM et al. Nonoperative management of pancreatic injuries in children. J Pediatr Surg.1998; 33: 343-49.

Ohno Y, Ohgami H, Nagasaki A, Hirose R. Complete disruption of the main pancreatic duct: a case successfully managed by percutaneous drainage. J Pediatr Surg 1995; 30:1741-42.

Burnweit C, Wesson D, Stringer D, Filler R. Percutaneous drainage of traumatic pancreatic cyst in children. J Trauma 1990; 30: 1273-77.

Jaffe RB, Arata JA, Matlak ME. Percutaneous drainage of traumatic pancreatic pseudocyst in children. AJR 1989; 152: 591-95.

Lucaya J, Vazquez E, Caballero F, Chait PG, Daneman A, Wesson D. Non-operative management of traumatic pancreatic pseudocyst associated with pancreatic duct laceration in children. Pediatr Radiol 1998; 28: 5-8.

Morali GA, Braverman DZ, Semesh D, Abanoritz Z, Jacob¬sohn WZ. Successful treatment of Pancreatic Pseudocyst with a somatostatin analogue and catheter drainage. Am J Gastroenterol 1991; 86:515-18

Martinez-Ramos D, Cifrian-Perez M, Gracia-Vila JH, Salvador-Sanchis JL, Hoashi JS. Percutaneous drainage treatment of traumatic pancreatic rupture with pancreatic transection. Gastroenterol Hepatol 2010; 33: 102-05

Cremer M, Deviere J, Engelholm L. Endoscopic Management of Cysts and Pseudocysts in Chronic Pancreatitis: Long-term follow-up after seven years of experience.GastrointestEndosc1989; 35:1-9.

Donnelly PK, Lavelle P, Carr-Locke D. Massive Hemor¬rhage following Endoscopic Transgastric Drainage of Pancreatic Pseudocyst. Br J Surg 1990; 77:758-59

Kozarek RA, Ball TJ, Patterson DJ, Freeny PC, Ryan JA, Traverso WL. Endoscopic Transpapillory Therapy for disrupted Pancreatic Duct and Peripancreatic Fluid collection.Gastroenterology1991;100: 1362-70.

Kamble RM, Cohen R, Williams S. Successful endoscopic drainage of a posttraumatic pseudopancreatic cyst in a child. Journal of pediatric Surgery 1999; 34: 1518-1520.

Chak A: Endo sonographic-guided therapy of pancreatic pseudocysts. Gastrointest Endosc 2000; 52: 23–27.

Yoder SM, Rothenberg S, Tsao K, Wulkan NL, Ponsky TA, St-Peter SD et al. Laparoscopic Treatment of Pancreatic Pseudocyst in Children. J Laparoendosc Adv 33. Bhattacharya D, Ammori BJ: Minimally invasive approaches to the management of pancreatic pseudocysts: review of the literature. Surg Laparosc Endosc Percutan Tech 2003; 13: 141–148.