Endoscopic transgastric drainage of a pancreatic pseudocyst with mediastinal and cervical extensions

Endoscopic management of pancreatic pseudocysts at atypical locations

“…The management options for these patients include conservative medical therapy, percutaneous drainage, endoscopic drainage or surgery. Most of the patients with pseudocysts at atypical locations have been treated either by surgery or by percutaneous drainage [2][3][4][5][6][7][8][9][10][11][12]. Literature assessing and supporting endoscopic drainage of pancreatic pseudocysts at atypical locations is scant and in the form of case reports only [2-4, 6, 8, 19].…”

“…While endoscopic drainage has been successfully used in patients with abdominal pseudocysts, there are only a few reports describing successful resolution of mediastinal pseudocysts with endoscopic interventions [3,6,8,19,[30][31][32][33][34][35]. Mallavarapu et al [31] reported two patients with mediastinal pseudocyst.…”

“…They are usually located in the peripancreatic region. Pseudocysts at atypical locations such as spleen, liver, mediastinum, pelvis, and kidney have also been rarely reported [2][3][4][5][6][7][8][9].…”

“…Because of their rarity, the published experience has been only in the form of case reports and the majority of these patients have been treated either by surgery or by percutaneous drainage [2][3][4][5][6][7][8][9][10][11][12].…”

"Mediastinal Pancreatic Pseudocyst - A Rare Cause of Dysphagia (Case Report)"

“…So he was advised to eat soft diet and review after 3 months, as spontaneous resolution is rare in these cases. Original Article DISCUSSION Mediastinal pseudocyst was first described in 1951 (1) and it remains a rare complication of pancreatitis. In general mediastinal pseudocyst occurs due to rupture of pancreatic duct posteriorly into retroperitoneal space & tracking of fluid through esophageal and aortic hiatus, hence posterior mediastinum is the most common location (2) .…”