We report a case of giant pancreatic pseudocyst after acute pancreatitis, successfully treated with saikokeishitokabushi. A 71-year-old man had been undergoing treatment in our hospital for cerebral infarction and diabetes. He was complicated with acute pancreatitis. He received conservative treatment, showing a tendency toward symptomatic improvement, although abdominal pain and anorexia subsequently developed. A giant pancreatic pseudocyst was identified on abdominal computed tomography. Therefore, we administered saikokeishitokabushi without changing the other oral medication. Many of his symptoms disappeared, and cyst reduction was noted. saikokeishitokabushi is generally prescribed for epigastric pain or anorexia after febrile illness. In this case, it is thought that saikokeishitokabushi exhibited an action leading to cyst reduction.
Acute pancreatitis ; Large ; Treated with ; Reduction (chemical) ; Pancreatic polypeptide, avian

A 65-year-old man was referred to our hospital in April 2003 with a pancreas tumor detected by a thorough medical checkup. Computed tomography (CT) showed swelling of the pancreatic body and tail, and magnetic resonance cholangiopancreatography (MRCP) showed only the main pancreatic duct in the head of the pancreas. Diagnosing autoimmune pancreatitis, we observed the patient without medication. However, one year later CT showed stenosis of the splenic artery and portal vein accompanied by development of collateral circulation around the pancreas. He had no symptoms, and CT showed no changes in the pancreatic swelling.;;He was admitted to our hospital on January 6, 2005, presenting with a history of jaundice which first appeared on January 1, 2005, and increased collateral circulation around the pancreas with pancreatic swelling were seen on CT. We started prednisolone therapy at 40 mg/day for exacerbation of autoimmune pancreatitis. Serum bilirubin levels improved from 11.9 mg/dl to 2.5 mg/dl, and pancreatic swelling also improved four weeks after starting therapy.;;We present a rare case of autoimmune pancreatitis that developed marked collateral circulations.
X-Ray Computed Tomography ; Pancreatitis ; Collateral Circulation ; Pancreatic polypeptide, avian ; Swelling