Presentation
Type 2 diabetes, non alcoholic, admitted for acute pancreatitis
Patient Data
Large and diffuse subcapsular collection of the liver associated with same-density fluid collections of the pancreatic body.
Dilated Wirsung canal and abnormal enhancement of the pancreatic body.
Right pleural and peritoneal effusion.
MRI showing a diffuse subcapsular fluid collection of the liver, hyperintense on T2 with internal debris, seemingly communicating with fluid collections of the pancreatic body.
Dilated Wirsung canal and abnormal enhancement of the pancreatic body.
Right pleural and peritoneal effusion.
Case Discussion
A hepatic sub-capsular pseudocyst is an exceptional complication of pancreatitis, usually involving the left lobe of the liver 1. It should be kept in mind when a patient presents with a sub-capsular hepatic collection in the setting of chronic or acute pancreatitis.
CT and a high level of amylase in the collection are useful for diagnosing this condition. In the presence of severe pain and large hepatic sub-capsular pseudocyst not resolving with conservative management, percutaneous drainage can be used, as it is both diagnostic and therapeutic 2.
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