An atypical presentation of a multiloculated giant pseudocyst of pancreas (original) (raw)
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A giant pancreatic pseudocyst compressing stomach and duedonum : a case report
Cumhuriyet medical journal, 2010
Different strategies for pancreatic pseudocysts drainage are available: endoscopic drainage, percutaneous drainage, or open surgery. Pancreatic pseudocysts may be treated endoscopically by internal drainage to a neighboring adherent viscus such as stomach, duodenum or jejunum. We present a case with a large pseudocyst treated surgically. We hereby reported a case which a 62-year-old male patient who has giant pancreatic pseudocyst causing of gastric and duodenal compression. Surgical cystogastrostomy drainage was successfully performed, resulting in complete resolution of the giant pancreatic pseudocyst. We suggest that surgical cystogastrostomy for giant pseudocyst of the pancreas is safe, feasible and it brings out a good outcome. Keywords: Pancreatic pseudocysts, gastric and duodenal compression, surgical cystogastrostomy Ozet Pankreatik psodokistlerin drenaji icin farkli stratejiler vardir: endoskopik drenaj, perkutan drenaj veya acik cerrahi. Pankreatik psodokistler mide, duode...
A giant pancreatic pseudocyst treated by cystogastrostomy
BMJ case reports, 2015
We report a case of a giant pancreatic pseudocyst in a 65-year-old man presenting with abdominal pain, loss of appetite and abdominal distension. CT scans demonstrated a giant pancreatic pseudocyst measuring 25.7 cm×15.3 cm×10.9 cm anteroposteriorly, with significant compression of surrounding organs. An open cystogastrostomy was performed through a midline incision, and 3 L of fluid was drained from the giant pseudocyst. Recovery has been uneventful.
Journal of the College of Physicians and Surgeons Pakistan Jcpsp, 2012
A 56 years old man presented with epigastric pain and abdominal distension. He suffered an attack of acute pancreatitis 6 weeks back followed by pseudopancreatic cyst formation. As the cyst kept on enlarging in size despite being on conservative management, the patient was operated after 5 weeks. A huge pancreatic pseudocyst was found containing about 4.5 liters of fluid. Cystogastrostomy was performed and the patient recovered un-eventfully. It was the third largest pancreatic pseudocyst reported so far.
BMC Research Notes
Background: Pancreatic cysts are being diagnosed more frequently because of the increasing usage of imaging techniques. A pseudocyst with the major diameter of 10 cm is termed as a giant cyst. Asymptomatic pseudo-cysts up to 6 cm in diameter can be safely observed and monitored without intervention, but larger and symptomatic pseudocysts require intervention. Case presentation: A 27-year-old Sri Lankan male, with history of heavy alcohol use, presented with progressive abdominal distension following an episode of acute pancreatitis. Contrast enhanced CT scan of the abdomen showed a large multilocular cystic lesion almost occupying the entire abdominal cavity and displacing the liver medially and the right dome of the diaphragm superiorly. The largest locule in the right side measured as 30 cm × 15 cm × 14 cm. Endoscopic ultrasound guided drainage of the cyst was performed. The cyst was entered into with an electrocauteryassisted cystotome and a lumen-opposing metal stent was deployed under fluoroscopic vision followed by dilatation with a 10 mm controlled radial expansion balloon. Repeat endoscopic ultrasound was done a week later due to persistence of the collection and a second stent was inserted. Then 10 French gauge × 10 cm double ended pigtails were inserted through both stents. The cysts were not visualized on subsequent Ultra sound scans. Stent removal was done after 3 weeks, leaving the pigtails insitu. The patient made an uneventful recovery. Conclusion: Giant pancreatic pseudocysts are rare and earlier drainage is recommended before clinical deterioration. Some experts suggest that cystogastrostomy may not be appropriate for the treatment of giant pancreatic pseudocysts and in some instances external drainage of giant pancreatic pseudocysts may be safer than cystogastrostomy. Video-assisted pancreatic necrosectomy with internal drainage and laparoscopic cystogastrostomy were also tried with a good outcome. With our experience we suggest endoscopic guided internal drainage as a possible initial method of management of a giant pseudo cyst. However long-term follow up is needed with repeated imaging and endoscopy. In instances where the primary endoscopic internal drainage fails, surgical procedures may be required as a second line option.
Inpatient Management and Treatment of a Giant Pancreatic Pseudocyst: A Case Report
Cureus, 2021
Pancreatic pseudocyst formation is a common sequela of pancreatitis caused by alcohol use or gallstones. Giant pancreatic pseudocyst is an infrequently reported but serious complication of pancreatitis. Due to the large volume of pancreatic fluid containing active enzymes, giant pancreatic pseudocysts may require surgical intervention. We report a case of a giant pancreatic pseudocyst in a 56-year-old-female with a history of heavy alcohol use presenting with shortness of breath, general malaise, and dyspnea on exertion. Initial computed tomography (CT) scan demonstrated a giant pancreatic pseudocyst measuring up to 22 cm in the largest diameter. The patient was hospitalized, and an endoscopic cystogastrostomy was performed. Once the patient was stabilized, the cystogastrostomy stent was removed and replaced with a pigtail catheter. CT scan at three-month follow-up demonstrated no evidence of fluid re-accumulation. Due to the large size of giant pancreatic pseudocysts, drainage of the pseudocyst is the most appropriate treatment. There are different treatment modalities to achieve the goal of draining pseudocysts. One of the most commonly used treatments is an endoscopic ultrasound-guided cystogastrostomy, which this case highlights as an acceptable treatment option for giant pancreatic pseudocyst.
Giant Pseudo Cyst of the Pancrease: A Case Report
EAS Journal of Medicine and Surgery
Pancreatic cysts are usually asymptomatic over 70% of the time. They can be benign or malignant. Enhanced imaging modalities and increased usage of routine imaging have increased the identification of pancreatic cysts. If symptomatic, abdominal pain or back pain, unexplained weight loss, jaundice, steatorrhea or palpable mass are usually the presenting complaints. Pancreatic cysts are typically assessed by crosssectional computed tomography (CT) and magnetic resonance imaging (MRI). In this article, we present a case of a 55-year-old female with a large pancreatic pseudocyst, initially measured 27 cm x 23 cm, who was subsequently admitted to our unit and managed successfully. Exploratory laparotomy and pancreatic cystogastrostomy. It is rare to come across a pseudocyst of such large dimensions. Despite its large size, the patient presented with vague abdominal pain as the only chief complaint. The unusual presentation of symptoms and the enormous size of the pseudocyst make this a u...
Laparoscopic Drainage of a Large Pancreatic Pseudocyst
JSLS, Journal of the Society of Laparoendoscopic Surgeons, 2012
Laparoscopic cystogastrostomy is an established procedure for the drainage of pancreatic pseudocysts. Cysts are mainly present in the lesser sac (retro-gastric), which is completely amenable to cystogastrostomy. We discuss the problems faced and simple solutions to the problems in managing a huge pancreatic pseudocyst of 22 cmϫ18 cm in a young boy 18 y of age.
Laparoscopic Cystogastrostomy in Pancreatic Pseudocyst with Minimal Invasion and Early Outcome
2019
Introduction: Pancreatic pseudocyst is a well circumscribed fluid collection, enclosed by a wall of inflammatory and fibrous tissue, arising in or adjacent to the pancreas. Pancreatic pseudocysts may occur after an episode of acute or chronic pancreatitis and in cases of pancreatic trauma. Available interventions include percutaneous, endoscopic or surgical approaches. Laparoscopy plays an important role in the management. Case Description: Here we report a case of pseudocyst in a 30-year-old man which was successfully managed laparoscopically with good outcome. Discussion: Small asymptomatic pseudocysts are known to regress spontaneously. Symptomatic, large or complicated pseudocysts need intervention. Laparoscopy has contributed immensely in the management of pseudocysts. It is associated with shorter hospital stay and fewer complications than traditional open methods. Conclusion: Laparoscopic technique for drainage of pseudocysts at our hospital shows that this approach is feasib...
Pseudocystectomy: An unusual operation for an atypical pancreatic pseudocyst
Surgical Practice, 2008
Pancreatic pseudocyst is an amylase-rich peri-pancreatic fluid collection devoid of epithelial lining. Occasionally, it cannot be differentiated from cystic neoplasm of pancreas and resections are required. We report a case of pancreatic pseudocyst masquerading cystic neoplasm treated with distal pancreatectomy. The investigation strategy and management of cystic lesions of the pancreas are also discussed.
Cardiovascular and Interventional Radiology, 1995
A case of an infected pseudocyst in the head of the pancreas is presented. Due to its small size and fistulization to the duodenum, a drainage catheter was placed through the fistulous tract from a distant transgastric approach. The fistula was balloon dilated to improve its emptying. Sixteen months later the patient remains asymptomatic with no recurrence of the pseudocyst.