Percutaneous management of a bladder-drained pancreas transplant pseudocyst by a transcystic approach.
BACKGROUND
We describe a 35-year-old male type 1 diabetic who underwent a cadaveric combined kidney-bladder-drained pancreas transplant with a duodenocystostomy for exocrine drainage who developed a large pelvic pseudocyst associated with a dilated pancreatic duct and an elevated serum amylase level.


METHODS
Due to the risk of surgical revision and the possibility of creating a cutaneous fistula with conventional percutaneous drainage, a pseudocyst-to-bladder drainage was performed. After the procedure, the catheter was capped to allow drainage of the pancreatic secretions into the bladder.


RESULTS
After drainage, the patient's serum amylase and lipase normalized along with resolution of the pseudocyst. The tube was removed after 19 weeks with no evidence of a recurrent pseudocyst and a normal serum amylase level.


CONCLUSIONS
The percutaneous pseudocyst-cystostomy obviated the need for surgical revision of the exocrine gland drainage and thus eliminated the morbidity and the potential risk of graft loss associated with such surgery.
Shlansky-Goldberg
R
R
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104, USA.
Cope
C
C
McGuckin
J
J
Jacobs
J
J
Sohn
J
J
Holland
T
T
Naji
A
A
Brayman
K
K
D000328:Adult; D000681:Amylases / Q000097:blood; D004322:Drainage; D006801:Humans; D008049:Lipase / Q000097:blood; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects*; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed
D008049:Lipase; D000681:Amylases