Pseudocyst intramural

Fig. 6.1. 6a,b. An intramural pseudocyst is demonstrated on CT as a well-defined, oval, low-attenuation mass related to the lesser curve of the stomach (a). The content was of fluid attenuation. Note the post-cholecystectomy clips. Endoscopy confirms the smooth submucosal mass (b), which disappeared spontaneously over the ensuing month... 

Vitello JM (1996) Gastric intramural pseudocyst with associated gastric outlet obstruction recognition and management. South Med J 89 534-537... 

Wagholikar GD, Ibrarullah M, Venkataramanapa M (2003) Gastric intramural pseudocyst-a complication of percutaneous drainage of an acute pancreatic pseudocyst. Am J Gastroenterol 98 229-231... 

Pancreatic pseudocysts are well known for their ability to migrate within the abdominal cavity as well as in some cases entering the chest. On rare occasions they can migrate into the wall of the stomach, giving rise to an intramural mass. If the situation is in the antrum, there have been reports of associated gastric outlet obstruction (Vitello 1996). 

Because of the retroperitoneal location of the duodenum and its close proximity to the pancreatic head, secondary inflammatory changes with oedema and mural thickening of the duodenal loop may result from adjacent acute pancreatitis (Fig. 9.11). Severe pancreatitis can also cause intramural duodenal hematoma (Abbas et al. 2002), and indeed in this situation thickening of the duodenal wall may lead to symptoms of bowel obstruction. Pancreatic pseudocyst following acute pancreatitis may also cause... 

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