Chronic pancreatic hematoma. Differential diagnosis with malignant tumor. Case report

Introduction: Chronic hematomas of the pancreas are rare and difficult to diagnose in children. The most relevant differential diagnosis include: pancreatic pseudocyst (when a history of trauma is referred) and pseudopapillary tumor of the pancreas (when a history of trauma is denied). The gold standard study imaging consists of an abdominal CT scan. In the case we present, the diagnosis was not made by CT, and could only be obtained after surgical biopsy. Case report. A case of a female adolescent with history of closed abdominal trauma 4 months before the onset of symptoms such as upper abdominal pain, nausea, vomiting, and weight loss of 8 kg. The CT image only revealed a cyst of the head of the pancreas. The differential diagnosis included: pancreatic pseudocyst vs. a malignant tumor. Surgery was indicated. During surgery, a pancreatic hematoma of the head of the pancreas was diagnosed, drained and marsupialized. The postoperative outcome was uneventful. Discussion. Hematomas of the pancreas are rare and difficult to diagnose. The most relevant differential diagnosis include: pancreatic pseudocyst and pseudopapillary tumor of the pancreas.