Case 294

 A seventy three-year-old male presented in our hospital for persistent pain in left lower abdomen. Medical palpation indicated soft and flat abdomen with slight tenderness at the left-sided area from belly button and with no peritoneal irritation symptoms. He was indicated to previously have cystic lesion at pancreatic tail in a local hospital. Laboratory test revealed red blood cells 5440000/mm3, white blood cells 16200/mm3, neutrophils 86.7%, CRP 0.41mg/dL, lipase 86 (12-53) U/L, Amylase 65 (44-132) U/L. For further investigation, abdomen CT was first taken (Figs. 1-3) then followed by contrast-enhanced CT (Fig. 4) and abdomen MRI (Figs. 5, 6).

What is your imaging diagnosis ?

1.　Pseudocyst and hemorrhage

2.　Intraductal papillary mucinous neoplasm and hemorrhage

3.　Mucinous cystadenoma and hemorrhage

4.　Cerous cystadenoma and hemorrhage

answer

2023.3.24