Clinical Evaluation of Endoscopic Ultrasonography on Diagnosis for Pseudocyst of the Pancreas Tail with Portal Hypertension -Report of a Case-

Kenji Dohden, Kenji Ohmura, Hiroshi Hikishima, Kouichi Hirose, Toshihiko Nakamura, Touru Watanabe, Takashi Iwa

First Department of Surgery, School of Medicine, Kanazawa University

A 42-year-old man was referred to our department because of the presence of a pancreatic tail cyst (5×4cm) with moderate splenomegaly. We diagnosed the condition as a benign pancreatic cyst with left-sided portal hypertension, from computed tomography, abdominal ultrasonography and endoscopic examination of the stomach. Moreover pre-operative endoscopic ultrasonography (EUS) showed multiple venous dilations (gastric varices) in the submucosal layer of the gastric fornix. We avoided cystogastrostomy and performed cystojejunostomy. Post-operative EUS showed improvement of the gastric varices. In this case EUS wa useful for pre- and post-operative evaluation of left-sided portal hypertension due to a pancreatic tail cyst and determination of the operative method for it in order to prevent post-operative bleeding.

Key words
left-sided portal hypertension, pancreatic tail pseudocyst, post-operative bleeding from gastrocystostomy

Reprint requests
Kenji Dohden First Department of Surgery, Kanazawa University School of Medicine
13-1 Takaramachi, Kanazawa, 920 JAPAN

Accepted
September 12, 1990

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