Emergent Pancreaticoduodenectomy for the Hemorrhagic Pancreatic Pseudocyst Fenestrating into the Duodenum: A Case Report

Yasuhiro Tsutani, Yoshiro Kubo, Minoru Tanada, Tomokazu Kakishita, Atsushi Okita, Isao Nozaki, Kazuhito Minami, Kenjiro Aogi, Akira Kurita and Shigemitsu Takashima

Department of Surgery, National Hospital Organization Shikoku Cancer Center

A 27-year-old man admitted for hematemesis with anemia was found in CT to have a 5-cm cystic mass in the pancreatic head and scattered calcification from pancreatic body to tail. Gastrointestinal fiberscopy showed a submucosal tumor in the second portion of the duodenum and active bleeding from the tumor center. Based on a diagnosis of pancreatic pseudocyst fenestration into the duodenum, we conducted emergency pancreaticoduodenectomy. Histopathologically, the tumor was diagnosed as a pancreatic pseudocyst fenestrating into the duodenum and connected to the main pancreatic duct. The postoperative course was uneventful and the man was discharged on postoperative day 18. Pancreatic pseudocysts fenestrating into the gastrointestinal organs is rare, especially into the duodenum.

Key words
pancreatic pseudocyst, gastrointestinal bleeding, pancreaticoduodenectomy

Reprint requests
Yasuhiro Tsutani Department of Surgery, Saiseikai Hiroshima Hospital
2-3-10 Kitashinchi, Saka-cho, Aki-gun, 731-4311 JAPAN

Accepted
September 28, 2005

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