Silent pancreatic pseudocyst. An unusual cause of extrahepatic biliary obstruction

• Published in: American journal of digestive diseases 1975-06, Vol.20 (6), p.583-587
• Main Authors: Falko, J M, Mekhjian, H S, Thomas, F B
• Format: Article
• Language: English
• Subjects: Adult; Cholangiography; Cholestasis - etiology; Common Bile Duct; Diagnosis, Differential; Erythrocyte Count; Female; Humans; Laparotomy; Leukocyte Count; Pancreatic Cyst - complications; Pancreatic Cyst - diagnosis; Pancreatic Neoplasms - diagnosis; Pancreatitis; Radioisotopes; Radionuclide Imaging; Selenium; Technetium
• ISSN: 0002-9211; 1573-2568
• DOI: 10.1007/BF01074942

Extrahepatic biliary obstruction due to mechanical obstruction of the common bile duct is a relatively rare complication of pancreatic pseudocyst. When jaundice does occur, clinical or laboratory evidence of associated primary hepatobiliary disease or acute pancreatitis has invariably been present. The patient described had a 3-month history of painless juandice, 40-lb weight loss, pruritus, and hepatomegaly, but no clinical or biochemical evidence of acute or chronic pancreatitis. After initial evaluation, including an abdominal echogram and a transhepatic cholangiogram, carcinoma of the head of the pancreas was diagnosed preoperatively. At laparotomy, a small pancreatic pseudocyst obstructed the terminal portion of the common bile duct. This case illustrates that a pancreatic pseudocyst should be considered in the differential diagnosis of obstructive jaundice, even in the absence of clinical evidence of pancreatitis or pseudocyst formation.