Unusual Configuration of a Giant Trans-Spatial Pancreatic Pseudocyst with Spontaneous Shrinkage: A Rare Case Report

Abstract Pancreatic pseudocysts are benign lesions that typically originate within the pancreatic parenchyma, or peripancreatic tissue. They commonly occur following recurrent episodes of pancreatitis or trauma. In this article, we present a case of a giant pancreatic pseudocyst with unusual trans-spatial extensions and spontaneous size decrement in a 40-year-old male patient with a history of alcohol abuse. He presented with chronic epigastric pain, and a physical examination showed only mild abdominal tenderness. Initial computed tomography showed a giant (18.4cm in its largest axis) pancreatic pseudocyst with left subdiaphragmatic and gastrohepatic extensions and concurrent splenic cysts. On follow-up ultrasound, the pseudocyst showed a significant spontaneous size decrement to less than half of its initial size. The giant size and trans-spatial characteristics of the pseudocyst, along with a relatively benign symptomatology and subsequent spontaneous shrinkage, constitute unique aspects of this case.