A giant retention cyst of the pancreas (cystic dilatation of dorsal pancreatic duct) associated with pancreas divisum

Zenichi Morise, Kazuo Yamafuji, Tadao Tsuji, Atsunori Asami, Kaoru Takeshima, Noritaka Hayashi, Hideo Baba, Fumiko Yoshida, Yuta Abe, Yasuyuki Tokura

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Abstract

We describe a rare case of pancreas divisum associated with a giant retention cyst (cystic dilatation of the dorsal pancreatic duct), presumably formed following obstruction of the minor papilla. The patient was treated by pancreatico(cysto)jejunostomy. A 50-year-old man was admitted with complaints of increasing upper abdominal distension and body weight loss. There was no previous history of pancreatitis, gallstones, drinking, or abdominal injury. An elastic-hard tumor-like resistance was palpable in the upper abdomen. Computed tomography and ultrasound (US) examinations revealed a giant cystic lesion expanding from the pancreas head to the tail. Endoscopic retrograde cholangiopancreatography findings showed a looping pancreatic duct which drained only the head and uncinate process of the pancreas to the main papilla. A US-guided puncture to the cystic lesion revealed that the lesion continued to the main pancreatic duct in the tail of pancreas. The lesion was connected to a small cystic lesion, which was located inside the minor papilla, and ended there. The amylase level in liquid aspirated from the cyst was 37869IU/l, and the result of cytological examination of the liquid showed class II. A pancreatico(cysto) jejunostomy was performed, with the diagnosis being pancreas divisum associated with a retention cyst following obstruction of the minor papilla. The histological findings of a specimen from the cyst wall revealed that the wall was a pancreatic duct covered with mildly inflammatory duct epithelium; there was no evidence of neoplasm. The patient is currently well, and a CT examination 2 years after the operation showed disappearance of the cyst and normal appearance of the whole pancreas.

Original languageEnglish
Pages (from-to)1079-1082
Number of pages4
JournalJournal of Gastroenterology
Volume37
Issue number12
DOIs
Publication statusPublished - 01-12-2002
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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    Morise, Z., Yamafuji, K., Tsuji, T., Asami, A., Takeshima, K., Hayashi, N., Baba, H., Yoshida, F., Abe, Y., & Tokura, Y. (2002). A giant retention cyst of the pancreas (cystic dilatation of dorsal pancreatic duct) associated with pancreas divisum. Journal of Gastroenterology, 37(12), 1079-1082. https://doi.org/10.1007/s005350200182