A 40-year-old man with a history of alcohol consumption of 25-year duration is admitted with a history of a 6-lb weight loss and upper abdominal pain of 3-weeks duration. Examination reveals fullness in the epigastrium. His temperature is 99, and his WBC count is 10,000. Which is the most likely diagnosis?
The presence of an epigastric mass 2-3 weeks after the onset of acute pancreatitis strongly favors a pancreatic pseudocyst. The history of alcoholism points to pancreatitis as a possible etiologic factor in the differential diagnosis. Pseudocysts develop in 10% of patients following acute pancreatitis. Most of these, however, resolve spontaneously. They may also develop in patients with chronic pancreatitis or after pancreatic trauma.
Pancreatic pseudocyst
Subhepatic abscess
Biliary pancreatitis
Cirrhosis
Pancreas