Context: An intra-hepatic pseudocyst is a very rare complication of acute and chronic pancreatitis with less than thirty cases described in the literature. Successful resolution of intra-hepatic pseudocysts with endoscopic transpapillary nasopancreatic drain placement has not previously been described.

Case Report: We report the case of a 34-year-old male with chronic idiopathic non-calcific pancreatitis, anomalous pancreatobiliary junction and a large intra-hepatic pancreatic pseudocyst along with a large abdominal pseudocyst who was successfully treated by endoscopic transpapillary nasopancreatic drainage alone.

Conclusion: Pancreatic pseudocysts can present as intra-hepatic cystic lesions and communicating intra-hepatic pseudocysts can be successfully treated by endoscopic transpapillary nasopancreatic drainage alone.

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