Agenesis of dorsal pancreas with eventration of diaphragm and intrapancreatic pseudocyst: a rare entity
A 43-year-old chronic alcoholic male patient presented in emergency with complaints of severe diffuse pain abdomen associated with vomiting of 2 h duration with a history of mild upper abdominal pain for last 15 days. He was not a known diabetic or hypertensive. On clinical examination, the patient had diffuse tenderness and distension of abdomen and no guarding or rebound tenderness. Laboratory investigations revealed leucocytosis with counts of 16,500, raised serum amylase and lipase with normal liver enzymes and alkaline phosphatase and random blood sugar was raised. X-ray chest and abdomen showed raised left hemidiaphragm and no air fluid levels or free gas under diaphragm. Ultrasonography of the abdomen did not reveal any significant abnormality. Diagnosis of acute pancreatitis was made and patient was managed conservatively and responded well to treatment but his blood sugar level remained high for which he was given insulin. Contrast enhanced computed tomography (CECT) of abdomen was performed after 6 days of admission, which showed intrapancreatic pseudocyst in the head of pancreas with dorsal agenesis of pancreas and eventration of left hemidiaphragm ( and ). Patient was discharged in stable condition after 9 days of admission on oral antibiotics and insulin.