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False‐positive diagnoses of pancreatic tail lesions caused by colon

False‐positive diagnoses of pancreatic tail lesions caused by colon The utility of ultrasound in diagnosis of pancreatic lesions is well known (1). Diagnosis of disease in the tail of the pancreas is made difficult by the proximity of the distal transverse colon and splenic flexure. The three cases of false-positive diagnosis of pancreatic tail lesions presented here point out the necessity of differentiating a feces-filled splenic flexure from a true lesion. CASE REPORTS Case 1 A 64 year old female entered with a 15month history of progressive anorexia and a 30-pound weight loss. No other symptoms were elicited. Physical examination was normal with the exception of tenderness in the supraumbilical area. Laboratory tests revealed microcytic anemia. Upper gastrointestinal and small bowel series, barium enema, and sigmoidoscopy were normal. Two ultrasound examinations performed 20 days apart revealed an ill-defined mass anterior to the left kidney (Fig. 1).Angiography revealed no abnormality in this region. Ultrasonically guided percutaneous fine needle aspiration of the mass yielded undigested fibers compatible with fecal aspirate. Exploratory laparotomy because of weight loss and pain revealed a fecesfilled splenic flexure directly anterior to the left kidney. The pancreas was normal. Case 2 A 28 year old male presented with a fourweek history of poorly localized abdominal http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Ultrasound Wiley

False‐positive diagnoses of pancreatic tail lesions caused by colon

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References (2)

Publisher
Wiley
Copyright
Copyright © 1977 Wiley Periodicals, Inc., A Wiley Company
ISSN
0091-2751
eISSN
1097-0096
DOI
10.1002/jcu.1870050513
Publisher site
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Abstract

The utility of ultrasound in diagnosis of pancreatic lesions is well known (1). Diagnosis of disease in the tail of the pancreas is made difficult by the proximity of the distal transverse colon and splenic flexure. The three cases of false-positive diagnosis of pancreatic tail lesions presented here point out the necessity of differentiating a feces-filled splenic flexure from a true lesion. CASE REPORTS Case 1 A 64 year old female entered with a 15month history of progressive anorexia and a 30-pound weight loss. No other symptoms were elicited. Physical examination was normal with the exception of tenderness in the supraumbilical area. Laboratory tests revealed microcytic anemia. Upper gastrointestinal and small bowel series, barium enema, and sigmoidoscopy were normal. Two ultrasound examinations performed 20 days apart revealed an ill-defined mass anterior to the left kidney (Fig. 1).Angiography revealed no abnormality in this region. Ultrasonically guided percutaneous fine needle aspiration of the mass yielded undigested fibers compatible with fecal aspirate. Exploratory laparotomy because of weight loss and pain revealed a fecesfilled splenic flexure directly anterior to the left kidney. The pancreas was normal. Case 2 A 28 year old male presented with a fourweek history of poorly localized abdominal

Journal

Journal of Clinical Ultrasound – Wiley

Published: Oct 1, 1977

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