Differential Diagnosis for Pancreatic Cyst/Pseudocyst Follow-up
Single Most Likely Diagnosis
- Residual or recurrent pancreatic pseudocyst: The patient has a history of distal pancreatectomy for a neuroendocrine tumor and a cystogastrostomy stent in place, which is consistent with a previous pancreatic pseudocyst. The decreased complex component involving the spleen and the slightly increased loculated simple fluid collection component below the spleen suggest a residual or recurrent pseudocyst.
Other Likely Diagnoses
- Pancreatic fistula: The presence of a cystogastrostomy stent and the loculated fluid collections suggest a possible pancreatic fistula, which is a known complication of pancreatic surgery.
- Abscess: The complex fluid collection involving the spleen could be an abscess, especially if there are signs of infection or inflammation.
- Hematoma: The loculated fluid collection could also be a hematoma, especially if there is a history of bleeding or trauma.
Do Not Miss Diagnoses
- Infected pancreatic pseudocyst: An infected pseudocyst can be life-threatening and requires prompt treatment. The presence of fever, leukocytosis, or other signs of infection would increase the suspicion for this diagnosis.
- Pancreatic necrosis: Pancreatic necrosis can occur after pancreatic surgery and can be a serious complication. The presence of necrotic tissue or gas in the pancreatic bed would increase the suspicion for this diagnosis.
- Malignant tumor recurrence: Although the patient had a neuroendocrine tumor resected, there is still a possibility of recurrence, especially if there are new or worsening symptoms.
Rare Diagnoses
- Pancreatic lymphangioma: A rare benign tumor that can occur in the pancreas and cause cystic lesions.
- Splenic cyst: A rare benign cyst that can occur in the spleen and cause fluid collections.
- Abdominal tuberculosis: A rare infection that can cause fluid collections and abscesses in the abdomen, including the spleen and pancreas.