Large Subcapsular Pseudocyst of Spleen Complicated by Chronic Pancreatitis

ABSTRACT

We present a 45-year-old man with chronic pancreatitis and the rare complication of large subcapsular splenic pseudocyst. He suffered from a slow growing left upper quadrant abdominal distension for 2 weeks and pain radiating to his back. On abdominal computed tomography, large subcapsular splenic pseudocyst (25x13x11 cm), multiple small sized pancreatic pseudocysts in the pancreas tail and chronic pancreatitis with multiple pancreatic stones were shown. He underwent percutaneous catheter drainage of the splenic pseudocyst and after 3 weeks, the size of the pseudocyst decreased. But, the pain radiating to his back and poor oral intake was not improved. Distal pancreatectomy, Roux-en-Y pancreaticojejunostomy, and splenectomy were performed and the patient was discharged after 2 weeks. A splenic subcapsular pseudocyst resulting from pancreatitis may be managed by percutaneous drainage, but according to a patient's clinical symptoms, operative management can be added.