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Intrahepatic pseudocyst following acute pancreatitis

Intrahepatic location of pancreatic pseudocyst is a rare manifestation of this common complication of acute pancreatitis. We present a case of 32-year-old man with pancreatic pseudocyst located in liver secondary to an episode of alcoholic pancreatitis. The patient presented with abdominal pain of 1-month duration associated with fever for 10 days. During admission, the patient underwent an abdominal computerized tomography (CT) scan which revealed two large-sized hypodense areas, one in liver and one in pancreas. A percutaneous needle aspiration of the liver was done under ultrasound guidance which showed elevated amylase level. Pigtail catheter was placed to drain the intrahepatic cyst. The patient responded well to this intervention treatment, and there were no complications on follow-up. Intrahepatic pseudocysts should be considered when an intrahepatic collection is encountered in patients with a recent episode of acute pancreatitis. CT associated with high levels of amylase in the hepatic collection is often helpful in diagnosing this unusual complication.