Traumatic pancreatic pseudocyst


  • A 26 years old injury
  • Alleged sports injury
  • Abdominal pain and persistent vomiting after collision with colleague during a futsal game.
CT scan abdomen in axial soft tissue window; plain (upper row) and contrasted (lower row).

CT scan findings:

  • A linear hypodensity at body of pancreas (red arrows) in keeping with laceration
  • Separation of proximal and distal part of the pancreas
  • Associated with surrounding hyperdense collection (yellow arrow)
Post contrast CT abdomen in axial plane soft tissue window

CT scan done 3 days after initial CT:

  • The previously seen laceration at body of pancreas is better demonstrated.
  • There is collection seen extending from this region into the lesser sac (white arrows).
  • The collection is multiloculated, hypodense and show wall enhancement post contrast
  • No evidence of vascular injury.
  • Splenic and portal veins are normal.

MRI and MRCP done 2 weeks later:

  • The previously seen collection adjacent to pancreatic laceration is still seen
  • No dilated intrahepatic duct or biliary tree or pancreatic duct

Diagnosis: Traumatic pancreatic pseudocyst.


  • Trauma to the pancreas constitutes 2% of all abdominal injuries.
  • One-third of pancreatic injuries are due to blunt injury.
  • Pancreatic injuries are associated with high mortality rate.
  • Complications of the injury including pancreatic abscess, fistulae, hemorrhage or pseudocyst.
  • Trauma is an etiological factor in 3-8% of adult pancreatic pseudocyst cases, but it is responsible for almost all pediatric pancreatic pseudocysts.
  • Pancreatic pseudocyst is a localized collection of pancreatic secretions lacking an epithelial lining as a result of pancreatic inflammation or ductal disruption.
  • It is seen on imaging as fluid-filled oval or round collections with a relatively thick wall.
  • They can be multiple and are most commonly located in the pancreatic bed. However, they can be found anywhere from the groin to the mediastinum and even in the neck.
  • Although pancreatic pseudocyst may regress on its own and requires no further treatment, interventions are required in selected cases
  • Those complicated with infections, large size causing mass effect symptoms such as gastric outlet obstruction, bowel obstruction, hydronephrosis and biliary obstruction, diameter increasing in size or greater than 5 cm, recurrence following previous resection or aspiration, and persistent symptoms may be treated with open surgical intervention, percutaneous or endoscopic drainage of collection.

Progress of patient:

  • Patient was managed non-operatively
  • He was discharged 17 days after admission
  • Recovered well
Author: radhianahassan