Pancreatic lesions and transfascial perirenal spread: Computed tomographic demonstration

Feldberg, M. A. M.; Hendriks, M. J.; Waes, P. F. G. M. van; Sung, Ki-Bum

doi:10.1007/bf01885120

Cited by 17 publications

(3 citation statements)

References 33 publications

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“…Pancreatic pseudocyst extending into perinephric space has been rarely reported, in ~ 0.9-1.25% of patients with pancreatitis [8]. Kashima et al reported a case of pancreatic pseudocyst penetrating into left renal subcapsular region with pancreatic ductal communication [9].…”

Section: Discussionmentioning

confidence: 99%

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A new page in the literature of pancreatic pseudocyst: case report on perirenal pseudocyst presenting as page kidney

Hiremath

Kuttancheri

Gurumurthy

et al. 2022

Egypt J Radiol Nucl Med

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Background Pancreatic pseudocysts are fluid collections encapsulated by a fibrous wall. They can dissect along any path of least resistance due to extravasation of enzymatic secretions into pancreatic and peripancreatic tissues. Pseudocysts extending into perirenal space are rarely encountered with paucity of data on the occurrence of secondary page kidney. We report one such rare case of pancreatic pseudocyst in the subcapsular plane of left kidney communicating with main pancreatic duct resulting in page kidney phenomenon due to compression. We discuss this case with emphasis on early identification and management of perirenal pancreatic pseudocyst, and to salvage the renal function. Case presentation An 83-year-old chronic alcoholic male presented with complaints of abdominal pain, generalized weakness, dyspnea and loss of appetite since 2 weeks. On admission, he was diagnosed with newly detected hypertension. Patient was subjected to ultrasound and CECT abdomen and pelvis, which suggested acute pancreatitis and perirenal pseudocyst showing patent communication with main pancreatic duct resulting in decreased renal cortical opacification. Ultrasound-guided fluid aspiration of the perirenal cyst was performed, which showed significantly elevated amylase and lipase levels with inflammatory cells, hinting at pancreatic origin. Subsequently, percutaneous drainage of the cyst was done. Conclusions Pancreatic pseudocysts at distant and atypical locations pose a diagnostic and therapeutic dilemma to the treating physician. Accurate clinical and radiological diagnosis of perirenal pseudocysts is extremely challenging. Early drainage of perirenal pancreatic pseudocyst prevents renal damage with subsequent pancreatic duct stenting avoiding its recurrence. Hence, it is of utmost importance as a radiologist to detect this uncommon complication at the earliest and guide the clinicians for efficient management.

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Section: Discussionmentioning

confidence: 99%

“…Digestion of perirenal fat and renal fascia due to seepage of the autolytic enzymes from the inflamed pancreas precedes renal pseudocyst formation [8]. Left kidney is more prone to experience perirenal pseudocysts due to its close anatomic relation with pancreas, whereas on right side, duodenum acts as a barrier [5,10].…”

Section: Discussionmentioning

confidence: 99%

A new page in the literature of pancreatic pseudocyst: case report on perirenal pseudocyst presenting as page kidney

Hiremath

Kuttancheri

Gurumurthy

et al. 2022

Egypt J Radiol Nucl Med

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“…Michiel et al described well circumscribed perirenal fluid collections in only 2 of the 105 cases of pancreatitis that were evaluated by CT 6. Pseudocysts affecting the kidneys are more common on the left1 since the left kidney shares a close anatomic relation with the pancreas; the duodenum being an anatomical barrier for the spread to the right side 5.…”

Section: Discussionmentioning

confidence: 99%

Page kidney due to a renal pseudocyst in a setting of pancreatitis

Aswani¹,

Anandpara²,

Hira³

2015

BMJ Case Reports

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SUMMARYPancreatic pseudocysts are notorious for their extension beyond the normal confines of the pancreatic bed due to dissection of the enzymatic pseudocyst fluid along fascial planes. Such collections of pancreatic juice may compress the kidney. Extension of the pseudocyst into the perirenal space is, however, uncommon. We report a case of pseudocyst of pancreas lying in the subcapsular plane of the left kidney with a patent communication with the pancreatic duct ( pancreaticorenal fistula). The compressive effect of the pseudocyst on the kidney compromised intrarenal perfusion as evidenced by a faint nephrogram but a normal renal artery. This led to reninangiotensin-aldosterone mediated hypertension-the Page kidney phenomenon. Extensive literature search revealed our case to be the only one to describe such an occurrence. BACKGROUND

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The Extraperitoneal Spaces: Normal and Pathologic Anatomy

Dynamic Radiology of the Abdomen

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Pancreatic lesions and transfascial perirenal spread: Computed tomographic demonstration

Cited by 17 publications

References 33 publications

A new page in the literature of pancreatic pseudocyst: case report on perirenal pseudocyst presenting as page kidney

A new page in the literature of pancreatic pseudocyst: case report on perirenal pseudocyst presenting as page kidney

Page kidney due to a renal pseudocyst in a setting of pancreatitis

The Extraperitoneal Spaces: Normal and Pathologic Anatomy

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