Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2021; 9(28): 8476-8481
Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8476
Percutaneous drainage in the treatment of intrahepatic pancreatic pseudocyst with Budd-Chiari syndrome: A case report
Gang Zhu, Yi-Sheng Peng, Cheng Fang, Xiao-Li Yang, Bo Li
Gang Zhu, Yi-Sheng Peng, Cheng Fang, Xiao-Li Yang, Bo Li, Department of General Surgery (Hepatobiliary Surgery), Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Li B and Yang XL proposed the idea and supervised, reviewed and edited the writing; Zhu G collected the data, analyzed the literature, and wrote the manuscript; Peng YS collected and analyzed the literature; Fang C assisted with literature analysis, manuscript preparation and image analysis; All authors read and approved the manuscript.
Supported by the National Natural Science Foundation of China, No. 81802778.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bo Li, PhD, Doctor, Department of General Surgery (Hepatobiliary Surgery), Academician (Expert) Workstation of Sichuan Province, The Affiliated Hospital of Southwest Medical University, No. 25 Taiping Street, Jiangyang District, Luzhou 646000, Sichuan Province, China. liboer2002@126.com
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: May 11, 2021
Revised: May 17, 2021
Accepted: August 9, 2021
Article in press: August 9, 2021
Published online: October 6, 2021
Abstract
BACKGROUND

Intrahepatic pancreatic pseudocyst (IHPP) is an extremely rare complication of acute pancreatitis, with only a few cases previously described in the literature. To the best of our knowledge, IHPP with Budd-Chiari syndrome (BCS) has not yet been described.

CASE SUMMARY

A 35-year-old male presented with abdominal pain, vomiting and anorexia, followed by severe swelling of the lower body after 4 d. The morphological assessment (using computed tomography revealed the presence of a huge cyst of 18.28 cm × 10.34 cm under the liver capsule accompanied by a large amount of ascites. Percutaneous puncture allowed us to detect a high level of amylase in the collection, confirming the diagnosis of IHPP. The cyst was treated by percutaneous drainage, producing complete resolution of the cyst.

CONCLUSION

IHPP can be treated with percutaneous drainage, endoscopic drainage, surgery or even conservative treatment, depending on the specific condition. We recommend percutaneous drainage as the first choice of treatment when IHPP with secondary BCS.

Keywords: Intrahepatic pancreatic pseudocyst, Pancreatic pseudocyst, Pancreatitis, Budd-Chiari syndrome, Percutaneous drainage, Case report

Core Tip: Intrahepatic pancreatic pseudocyst (IHPP) is a rare complication secondary to pancreatitis. We present herein, a rare case of IHPP with Budd-Chiari syndrome (BCS), developed in a male patient who had undergone left kidney surgery for kidney rupture due to pancreatitis. Cyst drainage analysis showed high levels of amylase. This case highlights that for BCS secondary to IHPP, emergency percutaneous drainage is a safe and effective treatment strategy.