eMedicine Specialties > Radiology > Gastrointestinal
Pseudocyst, Pancreatic: Multimedia
Updated: Aug 30, 2007
Multimedia
 | Media file 1: CT scan of a large symptomatic pancreatic pseudocyst abutting the posterior wall of the stomach (same patient as in Images 2-10). |
 | Media file 2: CT image of a pancreatic pseudocyst shows that it has a mature, thick capsule and that it adheres to the posterior wall of the stomach (same patient as in Images 1 and 3-10). |
 | Media file 3: CT image of a pancreatic pseudocyst suggests the complex nature of the pseudocyst, which is composed of 2 connected cavities (same patient as in Images 1-2 and 4-10). |
 | Media file 4: Intraoperative sonogram of a pancreatic pseudocyst (same patient as in Images 1-3 and 5-10). |
 | Media file 5: Intraoperative sonogram demonstrates internal echoes in pancreatic pseudocyst fluid (same patient as in Images 1-4 and 6-10). This finding suggests presence of necrotic debris or possible pus. |
 | Media file 6: Anterior gastrotomy was performed in a patient with a pancreatic pseudocyst (same patient as in Images 1-5 and 7-10). |
 | Media file 7: An intraoperative sonogram is used to guide needle placement through the posterior wall of the stomach and into a pancreatic pseudocyst (same patient as in Images 1-6 and 8-10). Fluid is aspirated to delineate placement of the cystgastrostomy site and to sample the fluid within. The needle is clearly depicted as the bright echogenic line entering the fluid-filled cavity. |
 | Media file 8: Complex fluid-containing necrotic debris is aspirated from a pancreatic pseudocyst (same patient as in Images 1-7 and 9-10). The pseudocyst was analyzed with Gram staining and contained no organisms or cells. |
 | Media file 9: Guidewire threaded through a needle and left in place to assist in creation of the cystgastrostomy in a patient with a pancreatic pseudocyst (same patient as in Images 1-8 and 10). |
 | Media file 10: Cystgastrostomy completed in a patient with a pancreatic pseudocyst (same patient as in Images 1-9). A portion of the pseudocyst capsule should be excised and sent to the pathology laboratory to ensure that no true epithelial lining is present. The posterior walls of the stomach and pseudocyst capsule are sewn together by using a hemostatic, running, interlocking suturing technique. |
 | Media file 11: CT scan of a pancreatic pseudocyst emanating from the tail of the pancreas (same patient as in Images 12-21). Contrast enhancement in the pseudocyst demonstrates a pseudoaneurysm of the splenic artery branch that had bled into the pseudocyst. |
 | Media file 12: CT scan (second in the sequence) of a patient with a pancreatic pseudocyst and an associated pseudoaneurysm (same patient as in Images 11 and 13-21). Heterogeneous appearance of the matter within the pseudocyst is consistent with a recent hemorrhage. |
 | Media file 13: CT scan (third in the sequence) in a patient with a pancreatic pseudocyst (same patient as in Images 11-12 and 14-21) demonstrates the relationship of the pseudocyst to the tail of the pancreas. |
 | Media file 14: Magnetic resonance cholangiopancreatogram of a pancreatic pseudocyst (same patient as in Images 11-13 and 15-21) demonstrates the pancreatic duct and pseudocyst well. |
 | Media file 15: Operative image in a patient with a pancreatic pseudocyst (same patient as in Images 11-14 and 16-21). In the surgeon's hand are the spleen, the pseudocyst, and the tail of the pancreas. |
 | Media file 16: Operative image (second in the sequence) in a patient with a pancreatic pseudocyst (same patient as in Images 11-15 and 17-21). The spleen, large pseudocyst, and distal pancreas are clearly depicted. |
 | Media file 17: Operative image (third in the sequence) in a patient with a pancreatic pseudocyst (same patient as in Images 11-16 and 18-21) shows the splenic artery coursing along the superior dorsal aspect of the pancreas. |
 | Media file 18: Operative image (fourth in the sequence) in a patient with a pancreatic pseudocyst (same patient as in Images 11-17 and 19-21) shows that the specimen, including a distal pancreatectomy, pseudocyst resection, and splenectomy site, has been removed. |
 | Media file 19: Operative image (fifth in the sequence) in a patient with a pancreatic pseudocyst (same patient as in Images 11-18 and 20-21) shows the oversewn stump of the pancreas. |
 | Media file 20: Operative image (sixth in the sequence) in a patient with a pancreatic pseudocyst (same patient as in Images 11-19 and 21) shows the gross resected specimen. |
 | Media file 21: Final operative image (seventh in the sequence) in a patient with a pancreatic pseudocyst (same patient as in Images 11-20) shows that the pseudocyst has been opened and that the clot it contained has been removed. |
 | Media file 22: CT scan (same patient as in Images 23-26) of pseudocyst causing gastric outlet obstruction. Cyst is in body of pancreas adjacent to the pylorus. Cyst-gastrostomy will not be possible. |
 | Media file 23: CT scan (same patient as in Images 22 and 24-26) confirms maturity of cyst as demonstrated by thick wall. |
 | Media file 24: CT scan (same patient as in Images 22-23 and 25-26)demonstrates large size of pseudocyst as measured by cursors. Based on chronicity, size and presence of symptoms, drainage of this cyst is indicated. |
 | Media file 25: Operative photo (same patient as in Images 22-24 and 26) demonstrating location of dependent portion of cyst near base of the mesentery. The entire cyst was in a location which precluded construction of a cyst-gastrostomy. |
 | Media file 26: Operative photo (same patient as in Images 22-25) shows successful drainage of pancreatic pseudocyst by construction of a Roux-en-Y cyst-jejunostomy. |
More on Pseudocyst, Pancreatic |
| Overview: Pseudocyst, Pancreatic |
| Imaging: Pseudocyst, Pancreatic |
| Follow-up: Pseudocyst, Pancreatic |
 Multimedia: Pseudocyst, Pancreatic |
| References |
| « Previous Page |
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Further Reading
Keywords
lesser sac fluid collection, acute fluid collection, internal pancreatic fistula, postnecrotic pseudocysts, retention cysts, pancreatic cysts, postnecrotic pseudocysts
