Case Report
Page Kidney Secondary to Pancreatic Pseudocyst: Definitive Surgical Management with Sustained Normotension: A Case Report with Literature Review
Venugopal H. G.
,
Mukund Mangarai*,
Akshay Patil
Issue:
Volume 10, Issue 2, December 2026
Pages:
67-73
Received:
7 July 2026
Accepted:
20 July 2026
Published:
10 August 2026
DOI:
10.11648/j.ijg.20261002.11
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Abstract: Background: Page kidney is an uncommon but reversible cause of secondary hypertension due to extrinsic compression of the renal parenchyma, triggering activation of the renin-angiotensin-aldosterone system (RAAS). Pancreatic pseudocysts are a well-recognized complication of acute or chronic pancreatitis and are a rare cause of this phenomenon. Case Presentation: A 21-year-old previously normotensive male presented to the Surgical Gastroenterology (SGE) Out-patient Department (OPD) with dull aching upper abdominal pain for 8 days and progressive abdominal distension for 6 months. At presentation patient had new-onset hypertension (150/100 mmHg) incidentally detected on admission. Contrast-enhanced computed tomography (CECT) of the abdomen revealed chronic calcific pancreatitis with a massive pancreatic tail pseudocyst (~1500 mL) extending into the left perirenal space, near-complete encasement of the left kidney, with a persistent nephrogram on delayed phase imaging, a pathognomonic radiological feature of ‘Page kidney’. The patient underwent laparotomy and Roux-en-Y cysto-jejunostomy in view of persistent abdominal symptoms and showed complete normalization of blood pressure. Patient remained normotensive and asymptomatic at 6 months on follow-up. Discussion: Page kidney secondary to a pancreatic pseudocyst is an exceptionally rare cause of secondary hypertension with very few cases reported in the world literature. All the patients reported in literature were managed conservatively by non-operative management, involving anti-hypertensives and USG (ultrasound) guided pigtail insertion. However, our case describes the management of a page kidney secondary to a pseudocyst by Roux-en-Y cysto-jejunostomy as a definitive therapy, achieving sustained medication-free normotension. Conclusion: Page kidney is a rare, curable cause of secondary hypertension. Early management helps prevent deterioration and salvage of renal function. Surgical drainage procedures are a feasible and durable alternative to conservative management in selected patients, particularly those with recurrent or complex pancreatic pseudocysts.
Abstract: Background: Page kidney is an uncommon but reversible cause of secondary hypertension due to extrinsic compression of the renal parenchyma, triggering activation of the renin-angiotensin-aldosterone system (RAAS). Pancreatic pseudocysts are a well-recognized complication of acute or chronic pancreatitis and are a rare cause of this phenomenon. Case...
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