MULTIPLE GIANT PSEUDOCYST OF PANCREAS: A RARE ENTITY

Author Name: 1Dr. ShaunakSaha, 2Dr. Deepak Holkar, 3Dr. Ali Reza, 4Prof. Dr. Sameer Kadam

Volume: 01 &  Issue:

Country: India

DOI NO.: 08.2020-25662434 DOI Link: http://www.doi-ds.org/doilink/12.2020-11279922/

Affiliation:

¹Junior Resident (3^rd year), Department of General Surgery, MGM Medical College and Hospital, Navi Mumbai, India

²Assistant Professor, Department of General Surgery, MGM Medical College and Hospital, Navi Mumbai, India

³HOU, Department of General Surgery, MGM Medical College and Hospital, Navi Mumbai, India

⁴HOD, Department of General Surgery, MGM Medical College and Hospital, Navi Mumbai, India

ABSTRACT

A pancreatic pseudocyst is defined as a peripancreatic fluid collection contained by a wall of fibrous granulation tissue that does not have an epithelial lining. A pseudocyst with diameter >10cm is termed as a Giant Pseudocyst. Multiple pseudocysts are a much rarer entity (≤20%) and have tendency to occur after chronic pancreatitis. A 36-year-old male patient, with a history of chronic and heavy alcohol use, presented with pain and distension of abdomen that was sudden in onset and was associated with early satiety and loss of appetite. CECT of abdomen revealed 2 inter-communicating cystic lesions in the abdomen with the right sided lesion (17 x 10 x 18 cm) pushing the liver and pancreas downwards and left sided lesion (13 x 12 x 11 cm) pushing the spleen downwards and the wall thickness being 1.1 cm. ICD was placed in the Right side in view of associated pleural effusion. After chest optimisation, ICD was removed and patient was taken up for Open Cystogastrostomy through a midline incision. Around 3L of fluid was aspirated. Recovery has been uneventful. Giant pancreatic pseudocysts are a rare entity and earlier drainage is recommended before surgery, although surgical drainage (laparoscopic or open) holds the upper hand in times of complications and clinical deterioration. In our case, open cystogastrostomy was done and the patient had complete and uneventful recovery

Key words: Pancreatitis, Pseudocyst of pancreas, giant, ICD, open cystogastrostomy, multiloculated.