Pancreatic pseudocysts located in the spleen and the liver, meet infrequently. They come to light not at once more
often as their clinical manifestations mask manifestations of the main disease
– pancreatitis. Located in the spleen is dangerous in connection with possibility of development of
massive hemorrhage and a rupture of spleen, and location in the liver can be
the cause of septic states at their suppuration.
Objective: to
analyse the experience of diagnostics and treatment of pancreatic pseudocysts
located in the spleen and the liver.
Materials and Methods: 37 patients with pancreatic pseudocysts located in an other organ (in the spleen - 33 (89,2%), in the liver - 4 (10,8%) were treated during 1985-2013. Men
prevailed - 83,8%, average age - 45±7 years. Ultrasound was carried out to all
patients before treatment.
Results: Ultrasound, besides characteristics of
pseudocysts of the spleen/liver, allowed to define manifestations of
pancreatitis and its prevalence also, that was important criteria in definition
of treatment tactics of these patients. Additional inspection (CT or/and MRI)
for the purpose of specification of ducts condition (pancreas/liver) and
prevalence of defeat was required in 8 (21,6%) cases only (location in spleen -
7, in
liver - 1).
Putreform contents wase in 85% among
pseudocysts of spleen location. External drainage under US-control, as the only
medical manual, is executed to 10 (30,3%) patients, distal resection with splenectomy
against calculous pancreatitis with primary damage of the pancreas tail executed
to 23 (69,7%) cases.
Pseudocysts of liver location were complicated
by suppuration in 100% and underwent external drainage under US-control with
evacuation and the subsequent fractional or flowing sanitation that was a final
type of treatment.
High level of amylase was revealed in the
received contents from pseudocysts in all cases of minimally invasive treatment.
Conclusion: Ultrasound
allows to estimate a condition of the patient at 78,4% of cases and to define
tactics of treatment of the patient.
Use the external minimally invasive manuals
under US-control allows to improve the results of treatment at this group of
patients as preoperative sanitation, and also as a final type of treatment, in
an optimum case.
