González RV, Marenco CC, Serrano LR, González DS, Martínez MAR, Montalvo JE

Language: Spanish
References: 14
Page: 54-58
PDF size: 93.58 Kb.

ABSTRACT

Objective: To describe the case of a female patient with a saccular aneurysm of the abdominal aorta simulating a pancreatic pseudocyst.
Setting: Third level health care hospital.
Description of the case: A female patient, 59 years old, with grade II obesity, without chronic-degenerating diseases, with antecedents of abdominal pain for the last 10 years. She started with pungent-type pain at the epigastrium, accompanied by nausea and vomit; these symptoms conditioned her hospitalization, diagnosing a neoplasia of the pancreas. At admission she presented these symptoms, and a 10 kg weight loss. Study protocol was started; clinically without alterations, ultrasonography and computerized axial tomography were performed, revealing the presence of a pseudocyst in the pancreas. Since no clinical patterns of a specific pathology were encountered, an exploratory laparoscopy was performed, during which a saccular aneurysm of the suprarenal abdominal aorta was found, it was resected successfully. The patient was discharged from the hospital after 10 days. The histopathological report confirmed the diagnosis, associating it to an atherosclerotic origin.
Conclusion: Only 5% of the abdominal aorta aneurysms are suprarenal, and less than 5% present a saccular shape, associating them more frequently with an infectious origin. Although they are infrequent, cysts of extra-pancreatic origin must always be taken into account.

REFERENCES

1. Svensson G, Crawford ES. Cardiovascular and vascular disease of the aorta. Philadelphia: W. B. Saunders; 1997.

2. Sabíston C Jr. Aortic abdominal aneurysms. In: Sabíston textbook of surgery. 15 th ed. Philadelphia: Saunders; 1997.

3. May J, White GH, Harris JP. Devices for aorta aneurysm repair. Surg Clin North Am 1999; 79: 507-27.

4. Long R, Guzman R, Greenberg H, Safneck J, Hershfield E. Tuberculous mycotic aneurysm of the aorta: review of published medical and surgical experience. Chest 1999; 115: 522-31.

5. Sternberg WC 3rd, Gonze MD, Garrad CL, Money SR. Abdominal and thoracoabdominal aortic aneurysm. Surg Clin North Am 1998; 78: 827-43 IX.

6. Bickerstaff LK, Hollier LH, Van Peenen HJ, Melton LJ 3rd, Pairolero PC, Chewy KJ. Abdominal aortic aneurysms: the changing natural history. J Vasc Surg 1984; 1: 6-12.

7. Yeo CJ, Sarr MG. Cystic and pseudocystic diseases of the pancreas. Curr Probl Surg 1994; 31: 165-243.

8. Cooperman AM. An overview of pancreatic pseudocyst: The emperor’s new clothes revisited. Surg Clin North Am 2001; 81: 391-7, xii.

9. Siegelman SS, Copeland BE, Saba GP, Cameron JL, Sanders RC, Zerhouni EA. CT of fluid collections associated with pancreatitis. AJR Am J Roentgenol 1980; 134: 1121-32.

10. Neff R. Angiography and interventional radiology: percutaneous approaches to benign pancreatic disorders. Surg Clin North Am 2001; 81: 359-61, xi.

11. Crawford ES, Crawford JL, Safi Hj, Coselli JS, Hess Kr, Brooks B, et al. Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients. J Vasc Surg 1986; 3: 389-404.

12. Pitchumoni CS, Agawal N. Pancreatic pseudocysts. When and how should drainage be performed? Gastroenterol Clin North Am 1999; 28: 615-39.

13. Warshaw AL, Compton CC, Lewandruwski K, Cardenosa G, Mueller PR. Cystic tumor of the pancreas. New clinical, radiologic, and pathologic observations in 67 patients. Ann Surg 1990; 212: 432-43; discussion 444-5.

14. Warshaw AL, Rutledge PL. Cystic tumor mistaken for pancreatic pseudocysts. Ann Surg 1987; 205: 393-8.