EDITOR'S QUIZ: GI SNAPSHOT
EDITOR’S QUIZ: GI SNAPSHOT
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From question on page 1372
With an initial diagnosis of pancreatic pseudocyst, transgastric endoscopic ultrasound-guided drainage of the cystic lesion was performed. Amylase level of drained fluid was extremely high (11 370 IU/l), gradually declining to 91 IU/l. Follow-up computed tomography showed a croissant-shaped mass adjacent under the cystic lesion (fig 1
). This mass was diagnosed as an accessory spleen on the basis of significant signal decrease as the splenic parenchyma on post-contrast T2-weighted image of superparamagnetic iron oxide-enhanced magnetic resonance imaging (fig 2 pre-contrast, fig 3 post-contrast). Distal pancreatectomy and splenectomy were performed. The cyst was surrounded by the accessory spleen (6.0x5.0x1.0 cm in size) and adhered to the pancreas. Pathological examination showed that the cyst wall was lined with stratified squamous epithelium, suggesting a diagnosis of an epidermoid cyst.
Figure 1 Computed tomography scan after endoscopic ultrasound-guided drainage. Black arrow, accessory spleen; S, spleen; C, | |||||||||
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Gut 2007 56: 1372.[Extract] [Full Text] [PDF]
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