Abstract

We present a 12-year old child who was admitted at the Emergency Department due to vague abdominal pain at the right upper quadrant and epigastric area with associated palpable mass and loose, watery stools. Initial workup included an abdominal ultrasound that revealed a hepatic abscess in the right lobe. With the presence of Entamoeba histolytica cyst on her stool exam, she was initially treated with metronidazole and antibiotic for amoebic liver abscess. Two weeks after treatment completion, severe abdominal pain recurred hence, she was re-admitted. An abdominal CT scan was requested that showed a large pancreatic head cyst. Because a cystic neoplasm cannot be ruled out, she was scheduled for intra-operative frozen section biopsy of the cyst wall before a possible excision or a roux-en-y cystojejunostomy. Frozen section biopsy of the cyst wall showed an epithelial lining within the cyst wall and subsequently a complete excision of the pancreatic head cyst was then performed. The unusual occurrence of the aforementioned condition in a young age group as well as the diagnostic and therapeutic dilemma in this case are therefore presented and discussed.

Keywords: Cystic Neoplasm of the Pancreas; Pancreatic Pseudocyst; Ultrasonography; Computed Tomography; Hepatic Abscess

References

1. 
   
   • Jarnagin William R., et al. Blumgart’s Surgery of the Liver Pancreas and Biliary Tract. 6th Ed. Philadelphia, USA. Elsevier, Inc., (2017).
   • Berger Nathan A. “New light on the pancreatic cyst conundrum”. Translational Cancer Research 7 (2018): S545-S548.
   • de Jong K., et al. “High prevalence of pancreatic cysts detected by screening magnetic resonance imaging examinations”. Clinical Gastroenterology and Hepatology 8.9 (2010): 806-811.
   • Keane MG., et al. “Risk of Malignancy in resected pancreatic mucinous cyst neoplasms”. British Journal of Surgery 105.428 (2018).
   • Gentimi FE., et al. “Pancreatic cystic lesion in an infant”. Journal of Indian Association of Pediatric Surgeons 16. (2011): 72-74.

2. 
   

Citation

Citation: Wilkinson B. Gacayan and Faisal K. Romancap. “A Diagnostic Dilemma of a Pancreatic Cyst in a 12-Year Old Child”. Acta Scientific Gastrointestinal Disorders 3.2 (2020): 01-03.

Copyright

Copyright: © 2020 Wilkinson B. Gacayan and Faisal K. Romancap. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.