Pancreatic pseudocysts located in the spleen: diagnostics and minimally invasive treatment

Congress:

ECR 2018

Poster Number:

C-0296

Type:

Educational Exhibit

Keywords:

Abdomen, Ultrasound, CT, MR, Drainage, Abscess

Authors:

Y. A. Stepanova, O. Zhavoronkova, D. Ionkin, M. Alimurzaeva; Moscow/RU

DOI:

10.1594/ecr2018/C-0296

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-0296

Fig. 1: Patient A., 41. Pancreatogenic abscess of the spleen before treatment,...

Fig. 2: Patient A., 41. Pancreatogenic abscess of the spleen before treatment, MR, T2...

Fig. 3: Patient A., 41. Pancreatogenic abscess of the spleen before treatment, MR, T2...

Fig. 8: Patient A., 41. Pancreatogenic abscess of the spleen after catheter drainage...

Learning objectives

Pancreatic pseudocysts (PP) are a characteristic complication for acute and chronic pancreatitis. Most pseudocysts are localized in the pancreas and only about 20% of them are extrapancreatic (pleura, mediastinum, liver, spleen, stomach, pelvis, etc.) [1-3]. The localization of pseudocysts into spleen is not so frequent. R. Heider and K.E. Behrns in 2001 showed that over 15 years they treated 238 patients with pancreatic pseudocysts, cysts were localized in spleen in 14 (5.9%) of them [4]. The involvement of the spleen is explained by the proximity...

Background

to analyse the experience of diagnostics and treatmrnt of PP located in spleen.

Findings and procedure details

33 patients with PP locaatedin spleen were estimated (ultrasound, CT or/and MRI) and treated (1985-2016). Men prevailed (84,8%), average age - 45±7 years. All patients underwent ultrasound with an evaluation of the spleen parenchyma, intraorganic blood flow, spleen artery and vein. The condition of the pancreas and retroperitoneal space was assessed without fail. In the presence of any disputable diagnostic issues, as well as with difficulty in visualization with ultrasound, computer tomography (CT) or magnetic resonance imaging (MRI) was performed. All formations were verified as...

Conclusion

As a complication of destructive pancreatitis, abscesses of the spleen can long remain unidentified and aggravate the course of the underlying disease, which requires a reminder to doctors about the possibility of such extra-pancreatic organ localization of PP. Ultrasound, CT or/and MRI, allows to estimate a condition of the patient and define treatment tactics.

Personal information

References

Hamm B., Franzen N. Atypically located pancreatic pseudocysts in the liver, spleen, stomach wall and mediastinum: their CT diagnosis. Rofo. 1993; 159: 522-527. 2. Guesmi F., Zoghlami A., Saidi Y., Najeh N., Dziri C.. Pancreatic pseudocysts located in the liver: a systematic review of the literature. Tunis Med. 2009 Dec; 87(12): 801-804. 3. Accetta P., Accetta I., Accetta R. et al. Pancreatic pseudocyst with splenic involvement. Case report. Rev Col Bras Cir. 2010 Dec; 37(6): 457-459. 4. Heider R., Behrns K.E. Pancreatic pseudocysts complicated by...