An atypical presentation of a multiloculated giant pseudocyst of pancreas

Giant pseudocysts of the pancreas are rare and difficult to manage. Pseudocysts are usually treated by cystogastrostomy but dependent drainage for giant pseudocysts may require alternative methods like cystojejunostomy. We report here a rare case of a multiloculated giant pseudocyst of pancreas which presented atypically with protrusion through the lesser omentum. The pseudocyst protruding through the lesser omentum filled the whole upper abdomen up to umbilical region and displaced the stomach inferiorly. The stomach which is usually displaced anteriorly by pseudocysts was unusually displaced and splayed on the inferior aspect of the pseudocyst. The anterior wall of the fundus and body of the stomach was adherent to the inferior aspect of the pseudocyst. The pseudocyst was managed by draining into the stomach in a different way by performing a cystogastrostomy to the anterior wall of the stomach. Giant pseudocysts are difficult to manage, and good imaging studies are helpful in selecting surgical options for dependent drainage. Cystogastrostomy on the anterior wall of the stomach is a feasible option to drain pseudocysts which are predominantly overlying and adherent to the anterior wall of the stomach.

A rare case of giant pseudocyst of pancreas extending up to anterior abdominal wall requiring Roux en Y cystojejunostomy

Pancreatic pseudocyst is rather a common complication following pancreatitis and chronic alcoholism related. Only few cases of giant pseudocyst measuring more than 10 cm of size or more in widest diameter has been reported in the literature. Possible attributable factors for less reported cases may be due to discripancies in sizing classification, in several studies the term 'large' or 'huge' were used instead of 'giant' when cyst measuring 10 cm or larger in its widest diameter. Pancreatic pseudocyst is usually sterile but when get secondarily infected may lead to life threatening complications such as pancreatc abscess which becomes very difficult to treat. Hence proper and timely intervention of giant pancreatic pseudocyst would probably reduce the risk of developing such dangerous complications. In the treatment of pancreatic pseudocyst to prevent recurrence and especially in protection of endocrine function of pancreas internal drainage is found to be more beneficial when compared to other modalities. This case demonstrates the successful use of Roux en Y cystojejunostomy to surgically drain a giant pancreatic pseudocyst at an unusual location.

Endoscopic Drainage of Giant Pancreatic Pseudocysts Using Both Lumen-Apposing Metal Stent and Plastic Stent: A Report of Two Cases and Review of the Current Literature

Introduction. A pancreatic pseudocyst (PP) with major diameter equal to 10 cm or more is called a giant pseudocyst. The ideal management for giant PPs is controversial. Endoscopic drainage is an alternative nonsurgical approach for PP management. Only a few cases of giant PPs were reported to be managed by endoscopic drainage. Case Presentation. We reported two cases of giant PPs following an episode of acute pancreatitis. Both were resolved following endoscopic cystogastrostomy using metallic and double-pigtail stents with excellent outcomes. There was no history of recurrence or complications on follow-up. In addition, we extensively reviewed all available literature studies of giant pancreatic pseudocyst presentation, management, and complications. We summarized all reported cases and presented them in a comprehensive table. Conclusion. The endoscopic cystogastrostomy approach is cost saving, can avoid surgical complications, and offers an early hospital discharge.

Fetal giant pseudocyst of meconium peritonitis: clinical observation

A case of prenatal ultrasound diagnosis of a giant pseudocyst in meconium peritonitis with successful surgical treatment is presented.

Abdominal Pseudocyst

We report clinical details and imaging findings of a case of a giant pseudocyst occurring in the anterior abdominal wall of a 61-year-old female. This was a late complication following the repair of an incisional hernia with mesh. Surgical excision revealed a well-encapsulated pseudocyst with histopathology confirming absence of epithelial cells. We further discuss current treatment methods for incisional hernias, as well as prevalence, etiology, and management of pseudocysts complicating hernioplasty.

Plastic treatment for giant pseudocyst after incisional hernia mesh repair: a case report and comprehensive literature review

Giant pseudocyst is a very rare complication after incisional hernia repair with mesh. We present a case of 54-year-old male patient with a giant pseudocyst, which developed after incisional hernia repair with mesh. A patient was discussed during multidisciplinary team meeting and operative treatment was suggested to the patient. Extirpation of the cyst was accomplished. There was observed no defect in the abdominal wall. The patient was discharged on the 7th postoperative day. Ultrasonography two weeks after discharge again showed fluid collection. There were 6 aspirations every week starting from 400 ml serous fluid at the beginning and 60 ml at the end. There were no signs of fluid collection one month after the last aspiration. Surgical plastic treatment of giant pseudocyst after incisional hernia mesh repair is safe and feasible despite its low prevalence.