Successful resolution of a mediastinal pseudocyst and pancreatic pleural effusion by endoscopic nasopancreatic drainage.
BACKGROUND
A mediastinal pseudocyst is an unusual complication of acute and chronic pancreatitis. The ideal form of management is controversial, and various successful therapeutic interventions including surgical resection, internal or external drainage, and non-operative radiological drainage techniques have been described. Successful resolution of a mediastinal pseudocyst with endoscopic transpapillary stent placement has been described in fewer than five cases.


METHODS
We report a case of chronic pancreatitis with complete pancreas divisum together with a mediastinal pseudocyst and pancreatic pleural effusion in which magnetic resonance imaging and endoscopic retrograde pancreatography demonstrated communication of the abdominal pseudocyst with the posterior mediastinum through the diaphragmatic hiatus. This case was successfully treated with endoscopic transpapillary nasopancreatic drain placement alone.


CONCLUSIONS
A communicating mediastinal pseudocyst can be successfully treated by endoscopic transpapillary nasopancreatic drainage alone.
Bhasin
Deepak Kumar
DK
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. dkbhasin@sancharnet.in
Rana
Surinder Singh
SS
Chandail
Vijant Singh
VS
Nanda
Mohit
M
Sinha
Saroj Kant
SK
Nagi
Birinder
B
D000328:Adult; D002908:Chronic Disease; D004322:Drainage / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008476:Mediastinal Cyst / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010192:Pancreatic Pseudocyst / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications*; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014057:Tomography, X-Ray Computed