Valproic acid 사용과 관련된 급성췌장염에 합병된 출혈성 가성낭종

발프로산은 가장 보편적으로 사용되는 항간질제로서 약제유발성 췌장염의 흔한가능한 원인으로 잘 알려져 있다. 그러나 발프로산 유발성 췌장염의 유해사례로서발프로산 유발성 췌장염의 국소 합병증으로서 췌장 가성낭종은 매우 드물며 주로 소아청소년기에 호발한다고 알려져 있다. 또한 이로 인한 발프로산 유발성 췌장염에 병발된 출혈성 가성낭종은 보고된 증례가 없을 정도로 드물다. 이에 본 저자들은 발프로산을 복약한 후 발생한 급성 출혈성 췌장 가성낭종을 경피적 배액술로 성공적으로 치료한 증례를 보고하고자 한다. The occurrence of valporic acid (VPA)-induced pancreatitis is a rare condition, predominantly observed in adolescent. Also, the occurrence of VPA-associated with hemorrhagic pseudocyst is extremely rare. We report the case of a 54-year-old man who had been taking VPA for uncontrolled seizures. He was admitted to our hospital with complaints of abdominal pain and diagnosed with acute on chronic pancreatitis. There were no other causes explaining pancreatitis, and it was thought to be due to VPA therapy. Despite of cessation of VPA, there was ongoing severe abdominal pain with fever. The patient underwent follow-up CT, which revealed a large loculated fluid collection that was observed with intra-cystic hemorrhage. After treatment with percutaneous catheter drainage, he was discharged with regression of the pancreatic pseudocyst. VPA-associated pancreatitis with hemorrhagic pseudocyst is rare but possible. Therefore, this possibility should be considered in the cause of hemorrhagic pseudocyst in a patient taking VPA. Korean J Pancreatobiliary 2014;19(4):194-198