Neonatal Med.  2019 May;26(2):117-120. 10.5385/nm.2019.26.2.117.

Multiple Congenital Pancreatic Cysts in a Neonate

• Kwon EM
• Shin J
• Jeon GW

• KMID: 2451610
• DOI: http://doi.org/10.5385/nm.2019.26.2.117

Abstract

Congenital pancreatic cysts are rare in newborn babies, and this makes prenatal diagnosis difficult. Diagnosis can be delayed for a few months after birth until the infant presents with an abdominal mass, abdominal distension, or vomiting due to gastric outlet obstruction. Excision of the cyst is the treatment of choice. A congenital pancreatic cyst should be considered if the fetus has an abdominal cyst without a definite origin. A prompt diagnosis is crucial to prevent fatal complications such as cholangitis, pancreatitis, cyst rupture, and peritonitis. We report a case of neonate with multiple congenital pancreatic cysts suspected prenatally to be stomach diverticulum or duplication cysts of the intestine.

Keyword

Congenital; Pancreatic cyst; Pancreatic pseudocyst; Infant, newborn

MeSH Terms

Cholangitis
Diagnosis
Diverticulum, Stomach
Fetus
Gastric Outlet Obstruction
Humans
Infant
Infant, Newborn*
Intestines
Pancreatic Cyst*
Pancreatic Pseudocyst
Pancreatitis
Parturition
Peritonitis
Prenatal Diagnosis
Rupture
Vomiting

Figure

• 

  Figure 1. Prenatal ultrasonography of the second fetus with abdominal cysts. Prenatal ultrasonography showing stomach diverticulum or duplication cysts of the intestine 10.6×18.2 mm in diameter (arrow).

• 

  Figure 2. An abdominal ultrasonography suggestive of a biliary atresia. Abdominal ultrasonography at the 16th postnatal day showing a collapsed gallbladder strongly suggestive of congenital biliary atresia (arrow).

• 

  Figure 3. Magnetic resonance cholangio-pancreatography showing multiple pancreatic cysts. (A) There are multiple, variable sized cysts in the pancreatic head and tail (arrows). (B) The largest pancreatic cyst, 16 mm in diameter, located in the pancreatic tail (arrow).

Reference

1. Auringer ST, Ulmer JL, Sumner TE, Turner CS. Congenital cyst of the pancreas. J Pediatr Surg. 1993; 28:1570–1.

2. Kazez A, Akpolat N, Kocakoc E, Parmaksiz ME, Koseogullari AA. Congenital true pancreatic cyst: a rare case. Diagn Interv Radiol. 2006; 12:31–3.

3. Castellani C, Zeder SL, Spuller E, Hollwarth ME. Neonatal congenital pancreatic cyst: diagnosis and management. J Pediatr Surg. 2009; 44:e1–4.

4. Boulanger SC, Gosche JR. Congenital pancreatic cyst arising from occlusion of the pancreatic duct. Pediatr Surg Int. 2007; 23:903–5.

5. Warnock WT, Khoshnam N, Bird KM, Schaffer LR, Lou LH, Hawkins CM, et al. Congenital cyst of the pancreas: a case report and review of literature. Fetal Pediatr Pathol. 2016; 35:265–71.

6. Jamila C, Nahla K, Saida H, Sameh A, Amine K, Mongi M, et al. Neonatal congenital pancreatic cyst: a report of three cases. J Preg Child Health. 2015; 2:179.

7. Alzaiem M, Zaiem F, Zaiem F. Congenital pancreatic pseudocyst presenting as neonatal ascites. J Pediatr Surg Case Rep. 2016; 11:44–6.

8. Bawazir OA, Al-Salem AH, Bawazir AO. Congenital pancreatic cyst: preoperative diagnosis and management. J Pediatr Surg Case Rep. 2017; 25:16–21.

9. Basturk O, Coban I, Adsay NV. Pancreatic cysts: pathologic classification, differential diagnosis, and clinical implications. Arch Pathol Lab Med. 2009; 133:423–38.

10. Sepulveda W, Carstens E, Sanchez J, Gutierrez J. Prenatal diagnosis of congenital pancreatic cyst: case report and review of the literature. J Ultrasound Med. 2000; 19:349–52.

11. Gerscovich EO, Jacoby B, Field NT, Sanchez T, Wootton-Gorges SL, Saroufeem R. Fetal true pancreatic cysts. J Ultrasound Med. 2012; 31:811–3.

12. Chak A. Endosonographic-guided therapy of pancreatic pseudocysts. Gastrointest Endosc. 2000; 52:S23–7.

13. Choi SJ, Kang MC, Kim YH, Lim JS, Lim SC, Chang JH. Prenatal detection of a congenital pancreatic cyst by ultrasound. J Korean Med Sci. 2007; 22:156–8.