Pancreatic serous cystadenoma with compression of the main pancreatic duct: an unusual entity.

Serous cystadenoma is a common benign neoplasm that can be managed without surgery in asymptomatic patients provided that the diagnosis is certain. We describe a patient, whose pancreatic cyst exhibited a radiological appearance distinct from that of typical serous cystadenoma, resulting in diagnostic difficulties. CT and MRI showed a 10 cm-polycystic tumor with upstream dilatation of the main pancreatic duct (MPD), suggestive of intraductal papillary mucinous tumor (IPMT). Ultrasonographic aspect and EUS-guided fine-needle aspiration gave arguments for serous cystadenoma. ERCP showed a communication between cysts and the dilated MPD, compatible with IPMT. The patient underwent left pancreatectomy with splenectomy. Pathological examination concluded in a serous cystadenoma, with only a ductal obstruction causing proximal dilatation.

Rupture of the common iliac artery following anal sex.

We describe the case of a young man admitted with acute onset of pain and defense in the left iliac fossa a few hours after rectal introduction of a dildo. At laparotomy a retroperitoneal haematoma was found along with a dissection of the left common iliac artery. No rectal perforation was identified. Aorto-iliac prosthetic bypass was necessary for repair.