Pancreatic pseudocyst, pancreatitis, and incomplete pancreas divisum in a child treated with endotherapy: a case report

Pancreatic divisum (PD) is caused by the lack of fusion of the pancreatic duct during the embryonic period. Considering the incidence rate of PD, clinicians lack an understanding of the disease, which is usually asymptomatic. Some patients with PD may experience recurrent pancreatitis and progress to chronic pancreatitis. Recently, a 13-year-old boy presented with pancreatic pseudocyst, recurrent pancreatitis, and incomplete PD, and we report this patient’s clinical data regarding the diagnosis, medical imagining, and treatment. The patient had a history of recurrent pancreatitis and abdominal pain. Magnetic resonance cholangiopancreatography was chosen for diagnosis of PD, pancreatitis, and pancreatic pseudocyst, followed by endoscopic retrograde cholangiopancreatography, minor papillotomy, pancreatic pseudocyst drainage, and stent implantation. In the follow-up, the pseudocyst lesions were completely resolved, and no recurrent pancreatitis has been observed.

Endoscopic Ultrasound Guided Pancreatic Pseudocyst drainage experience at a tertiary care unit

Objective: To evaluate the clinical success, technical success and complications related to Endoscopic ultrasound (EUS) guided Pancreatic pseudocyst (PPC) drainage. Methods: This retrospective study was conducted on the patients with symptomatic PPC who presented over a period of three years, between January 2015 and September 2018, at Endoscopic Suite of Surgical Unit 4, Civil Hospital, Karachi. Record was analyzed for demographic data, indications for the procedure, complications and success related to EUS guided drainage. Statistical analyses were performed using the SPSS Version 22. Results: Total number of patients was 71. Mean age was 37.20 ± 17.27 years with a range of 6 to 68 years. Complications occurred in 12 (8.52%) patients, including stent migration (5/12), bleeding (4/12), infection (1/12), intra-abdominal abscess (1/12) and perforation (1/12). Technical success was achieved in 100% and clinical success in 97.1%. There was no procedure-related mortality. Conclusion: Pancreatic pseudocyst (PPC) is a known complication of acute as well as chronic pancreatitis which can have dreaded and appalling effects. In this part of the world with limited and scarce resources, EUS guided drainage of PPC is most feasible and rational with minimal complications, thus making it a front runner procedure. doi: https://doi.org/10.12669/pjms.36.4.1442 How to cite this:Kazim E, Taj MA, Zulfikar I, Azeem J. Endoscopic Ultrasound Guided Pancreatic Pseudocyst drainage experience at a tertiary care unit. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1442 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.