Emergent Pancreaticoduodenectomy for the Hemorrhagic Pancreatic Pseudocyst Fenestrating into the Duodenum: A Case Report

Abstract

A 27-year-old man admitted for hematemesis with anemia was found in CT to have a 5-cm cystic mass in the pancreatic head and scattered calcification from pancreatic body to tail. Gastrointestinal fiberscopy showed a submucosal tumor in the second portion of the duodenum and active bleeding from the tumor center. Based on a diagnosis of pancreatic pseudocyst fenestration into the duodenum, we conducted emergency pancreaticoduodenectomy. Histopathologically, the tumor was diagnosed as a pancreatic pseudocyst fenestrating into the duodenum and connected to the main pancreatic duct. The postoperative course was uneventful and the man was discharged on postoperative day 18. Pancreatic pseudocysts fenestrating into the gastrointestinal organs is rare, especially into the duodenum.