Published online May 27, 2015. doi: 10.4240/wjgs.v7.i5.82
Peer-review started: November 3, 2014
First decision: December 12, 2014
Revised: January 2, 2015
Accepted: April 10, 2015
Article in press: April 14, 2015
Published online: May 27, 2015
Processing time: 196 Days and 20 Hours
Pseudocyst formation is a common complication of acute and chronic pancreatitis. Most common site of pseudocyst is lesser sac; mediastinal extension of pseudocyst is rare. Other possibilities of posterior mediastinal cyst must be considered. This patient presented with computed tomography abdomen with thorax showing a large thoraco-abdominal pseudocyst with right sided pleural effusion. It was confirmed to be pancreatic pseudocyst by analyzing fluid for amylase and lipase during surgery. In our patient, the pseudocyst was accessible transabdominaly. Cystogastrostomy was not possible as it was causing twisting of cardio-esophageal junction; we did retrocolic and retrogastric Roux-en-Y cystojejunostomy. Only two such cases were reported in literature.
Core tip: Thoraco-abdominal pseudocyst is rare location of pancreatic pseudocyst. Other possibilities of posterior mediastinal cyst must be considered. Internal drainage is a definitive management but will be difficult. Retrocolic retrogastric Roux-en-Y cystojejunostomy is feasible option. Only two such cases were reported in literature.