An Atypical Vascular Complication: Splenic Vein Varix in a Pancreatic Pseudocyst

This report describes the case of a 62-year-old male with a history of idiopathic acute pancreatitis and pseudocyst. Contrast-enhanced computed tomography (CECT) showed a thick-walled pseudocyst arising from the tail of the pancreas. Notably, a hypodense lesion with homogenous enhancement was identified within the posterosuperior aspect of the pseudocyst, communicating with the splenic vein, exhibiting imaging characteristics of a splenic vein varix. There was no sign of active bleeding or splenic vein thrombosis. The patient was managed conservatively, with continued drainage of the pseudocyst, and is on clinical follow-up. This case illustrates the detection of a vascular lesion within a pseudocyst using imaging, which aids in the planning of the patient's management.