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Left-sided portal hypertension caused by serous cystadenoma of the pancreas: Report of a case

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Abstract

We report a case of serous cystadenoma of pancreas causing left-sided portal hypertension and gastric varices. A 68-year-old man was admitted for treatment of a pancreatic body tumor. Contrast-enhanced computed tomography (CT) showed a honeycombed cystic mass. A celiac angiogram showed a hypervascular tumor supplied mainly by a dilated splenic artery and dorsal pancreatic artery. In the venous phase, the patent splenic vein had a large hepatopetal collateral vein via the coronary gastric vein. Upper gastrointestinal endoscopy showed isolated varices of the gastric fundus. We made a preoperative diagnosis of a serous cystic tumor of the pancreas with left-sided portal hypertension and performed distal pancreatectomy with splenectomy. The resected tumor was 8 cm in diameter and had a typical honeycombed microcystic pattern with central stellate scarring. The spleen was not enlarged. Histopathological examination confirmed a diagnosis of serous cystadenoma without any sign of malignancy. Postoperative endoscopy showed disappearance of the gastric varices.

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, Tokyo Medical and Dental University, Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Koji Ito, Atsushi Kudo, Noriaki Nakamura, Shinji Tanaka, Kenichi Teramoto & Shigeki Arii

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  1. Koji Ito
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  2. Atsushi Kudo
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  3. Noriaki Nakamura
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  4. Shinji Tanaka
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  5. Kenichi Teramoto
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  6. Shigeki Arii
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Ito, K., Kudo, A., Nakamura, N. et al. Left-sided portal hypertension caused by serous cystadenoma of the pancreas: Report of a case. Surg Today 38, 184–187 (2008). https://doi.org/10.1007/s00595-007-3600-y

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  • DOI: https://doi.org/10.1007/s00595-007-3600-y

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