Uncommon Location for a Large Hepatic Subcapsular Pancreatic Pseudocyst: A Rare Case Report and Review

The pancreatic pseudocyst is a collection of pancreatic fluid surrounded by a non-epithelialized wall composed of granulation tissue and fibrosis, occurring in approximately 10% of patients diagnosed with acute pancreatitis and in 20–38% of those with chronic pancreatitis. Most pseudocysts are situated in the head and pancreatic body, but about 20% developed in extrapancreatic locations. We present the case of a 46-year-old male patient diagnosed with chronic alcohol pancreatitis with acute exacerbation, who developed a large pancreatic pseudocyst with subcapsular location in the right hepatic lobe, successfully treated by laparoscopic surgical drainage. The computed tomography scan and postoperative biochemical analysis of the intracystic fluid played a key role in establishing the diagnosis of this rare condition. Intrahepatic pancreatic pseudocyst is a rare location of pancreatic pseudocysts, but the one located in the right hepatic lobe is an extremely rare location. The treatment of intrahepatic pancreatic pseudocysts may be conservative, or endoscopic, percutaneous, or surgical drainage may be necessary. The presence of symptoms, signs of extrinsic compression or complications require drainage of the pseudocyst.