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Spontaneous rupture of a pancreatic pseudocyst into the duodenum.

The natural history of pancreatic pseudocyst occasionally terminates with rupture into either the peritoneal cavity or a hollow viscus. Rupture into the duodenum, however, is extremely rare; the world literature contains but two documented reports of this complication. 1 This report details the third such case, reviews the pertinent literature, and discusses the radiologic diagnosis. Report of a Case A 46-year-old Negro man was admitted to the Greenpoint Hospital on Dec 29, 1968, with the complaint of epigastric pain and vomiting of two days' duration. He admitted to the daily consumption of large quantities of alcohol and had been hospitalized twice during the preceding year for treatment of acute pancreatitis. Upper-gastrointestinal tract x-ray films were normal during the first admission (Fig 1). At the second admission, nine months before the current hospitalization, repeat examination showed the stomach and duodenal bulb to be intrinsically normal. The entire descending portion of the