Abstract
The patient was a 50-year-old man, who had stayed inside his home without going out for about 25 years, had drunk alcohol heavily, and had noticed to have frequent bouts of abdominal pain. In May 2005, his upper abdominal pain suddenly became serious and he was emergently admitted to the hospital. On admission he had a high fever, 38.1°C, and there were tenderness and muscular guarding mainly in the upper abdomen. Abdominal CT scan revealed an about 60-mm sized pancreatic cyst which had formed a mass with the pancreas tail and transverse colon and had an inner portion suggestive of hemorrhage. Thus peritonitis due to a ruptured pancreatic cyst was diagnosed, and excision of the pancreatic body and tail with associated splenectomy and extended right hemicolectomy was performed on the same day.
At present when techniques of non-surgical intervention have developed, pancreatic pesudocysts which do not disappear spontaneously are treated by non-operative treatments such as percutaneous drainage under US/CT guidance, and rarely demand emergency operation like our case. However, in the case in which abrupt and severe peritonitis develops due to intracystic bleeding or rupture of the cyst, we have to decide therapeutic guideline including surgical therapy as prompt as possible.
