POCUS-Detected Pancreatic Pseudocyst in Chronic Pancreatitis: Beyond the Flare

Author: Dr Himanshu Gul Mirani, Dr Ernest Mbama 

Institution: Midland Metropolitan University Hospital, Birmingham 

A 63-year-old male with a history of alcohol misuse and chronic pancreatitis presented with abdominal pain and vomiting. While a chronic pancreatitis flare was initially suspected, concern for an abdominal aortic aneurysm prompted point-of-care ultrasound (POCUS). Incidentally, a well-defined, fluid-filled cystic structure was visualized. CT abdomen confirmed a pancreatic pseudocyst, and the patient was admitted for consideration of drainage. Pseudocysts are a common complication of chronic pancreatitis due to pancreatic duct disruption and enzyme leakage. They can cause non-specific symptoms and be mistaken for routine disease flares. Timely identification through bedside imaging can alter management significantly, preventing complications such as infection, hemorrhage, rupture, or gastric outlet obstruction. This case highlights the value of maintaining a broad differential in patients with recurrent pancreatitis symptoms and demonstrates the utility of POCUS in early detection of clinically significant complications, prompting appropriate referral and intervention.