Fethi Guesmi
Ayoub Zoghlami
Yosri Saidi
Nabil Najeh
Chedli Dziri


Background: Pancreatic pseudocysts (PC) are a common complication of both acute and chronic pancreatitis. Most pancreatic pseudocysts are located within the head and the body of the pancreas, but 20% of them are extrapancreatic (pleura, mediastinum, pelvis and spleen). The location of a pseudocyst in the liver is an exceptional event, only thirty three cases are reported in the literature.
Aim: This article aimed to report a new case of PC located in the liver combined with a systematic review of reported cases published in peer-reviewed journals.
Methods: A new case of PC located in the liver was reported. An extensive electronic search of the relevant literature since 1990 was carried out using Medline. We retained only the articles reporting one or several cases. When the article was unavailable, we considered the relevant abstracts which should report clinical patterns and therapeutic modalities. Reviews of the literature, systematic reviews, letters to editors and incomplete abstracts were excluded. A descriptive analysis of the collected sample including our case was performed. Morphological, therapeutic and outcome variables were reported.
Results: The analysis of 22 cases reported in the literature and our observation provided the following data: 17 men and 6 women with a mean age of 51±3,2 years. Seventeen patients presented an acute pancreatitis, complicating a chronic pancreatitis in seven cases, alcoholic in six cases, biliary in three cases and traumatic in one case. Six patients presented a chronic pancreatitis. The PC was located in the left lobe of the liver in 12 cases, in the right lobe in 6 cases and
interested the two lobes in 5 cases. The lesion was unique in 8 patients and multiple in 15 patients. Fifteen patients were treated by Ultrasound or CT guided percutaneous drainage. Four patients were managed surgically. Three patients had no specific treatment. One patient was successfully treated by endoscopic transpapillary drainage. The evolution was favourable for all patients except in three patients who died.
Conclusions: Pancreatic pseudocyst located in the liver is an exceptional event, commonly following acute pancreatitis, rising in older male, involving the left lobe of the liver and treated by percutaneous drainage.


Pancreatic pseudocyst, liver



  1. Mofredj A, Cadranel JF, Dautreaux M. Pancreatic pseudocyst located in the liver: a case report and literature review. J Clin Gastroenterol. 2000;30:81-3.
  2. Wang SJ, Chen JJ, Changchien CS. Sequential invasions of pancreatic pseudocysts in pancreatic tail, hepatic left lobe, caudate lobe, and spleen. Pancreas. 1993; 8:133-4.
  3. Castaing D, Smail A. Anatomie du foie et des voies biliaires. Encycl Méd (Elsevier, Paris). Hépatologie, 7-001-A-10.
  4. Okuda K, Sugita S. Hepatobiliary images. Pancreatic pseudocysts in the liver. J Gastroenterol Hepatol. 1998; 13:433- 6.
  5. Mehler CI, Soyer P, Kardache M. Computed tomography of intrahepatic pancreatic pseudocysts. J Radiol. 1998; 79:751-5.
  6. Scappaticci F, Markowitz SK. Intrahepatic pseudocyst complicating acute pancreatitis: imaging findings. AJR. 1995; 165:873-4.
  7. Lederman E, Cajot O, Canva-Delcambre V. Pseudokystes du foi gauche: une complication inhabituelle de la pancréatite aiguë. Gastroenterol Clin Biol.1997; 21:340-1.
  8. Sugiyama H, Sasaki M, Asano T. A case of pancreatic pseudocyst intruded into the left lobe of the liver. Nippon Shokakibyo Gakkai Zasshi.2000; 97:605-11.
  9. Okuda K, Sugita S, Tsukada E, Sakuma Y, Ohkubo K. Pancreatic pseudocyst in the left hepatic lobe: a report of two cases. Hepatology. 1991; 13:359-63.
  10. Ancel D, Lefebvre M, Peyrin-Biroulet L. Pancreatic pseudocysts of the right hepatic lobe during acute biliary pancreatitis. Gastroenterol Clin Biol. 2005;29:743-5.
  11. Balzan S, Kianmanesh R, Farges O. Right intrahepatic pseudocyst following acute pancreatitis: an unusual location after acute pancreatitis. J Hepatobiliary Pancreat Surg. 2005; 12: 135-7.
  12. Shibasaki M, Bandai Y, Ukai T. Pancreatic pseudocyst extending into the liver via the hepatoduodenal ligament: a case report. Hepatogastroenterology. 2002;49:1719-21.
  13. David C, Sabater L, Calvete J. Multiple intrahepatic pseudocysts in acute pancreatitis. World J Gastroenterol.2007; 13:4655-7.
  14. Slim K, Hendaoui L, Larabi B. Pseudo-kystes intra-hépatiques multiples au cours d'une pancréatite aiguë. Gastroenterol Clin Biol.1992 ; 16 :902.
  15. Aiza I, Barkin JS, Casillas VJ, Molina EG. Pancreatic pseudocysts involving both hepatic lobes. . Am J Gastroenterol. 1993; 88:1450-2.
  16. Gamanagatti S, Kandpal H, Mishra V. Acute pancreatitis complicated by intrasplenic and intrahepatic pseudocysts. European Journal of Radiology Extra. 2006;60:29-31.
  17. Bayo Poleo R, Zaheri M, Córdoba López A. Bleeding intrahepatic cyst in a patient with chronic pancreatitis. Gastroenterol Hepatol. 1997; 20:46-7.
  18. Kralik J, Pesula E. A pancreatic pseudocyst in the liver. Rozhl Chir. 1993; 72:91-3.
  19. Les I, Cordoba J, Vargas V. Pancreatic pseudocyst located in the liver.Rev Esp Enferm Dig. 2006; 98:616-20.
  20. Bhasin DK, Rana SS, Chandail VS. An intra-hepatic pancreatic pseudocyst successfully treated endoscopic transpapillary drainage alone.JOP.2005;6:593-7.