Intramural pseudocysts of the upper gastrointestinal tract

Abstract

Background:Intramural pseudocysts or pseudocysts occurring in the gastrointestinal tract (GIT) wall are rare and there is a paucity of data on their clinical features and management.Patients and Methods:We retrospectively evaluated patients with intramural pseudocysts seen at our institution over the past 6 years. Intramural location was confirmed either on surgery or endoscopic ultrasound (EUS). Depending upon the symptoms, their control with the conservative medical therapy and procedural consent, the patients underwent EUS guided single time aspiration of the pseudocyst or transmural drainage or transpapillary drainage or surgery.Results:A total of 9 patients with intra mural pseudocysts (male: n = 8; mean age ± SD: 39.3 ± 8.0 years; age range: 24-54 years; five patients having chronic and four patients having acute pancreatitis) were studied. The pseudocysts were located in the wall of the second part of the duodenum in five patients, in the gastric wall in three patients and in the lower esophageal wall in one patient. The size of the pseudocysts ranged from 8 mm to 8 cm and 3/9 (33%) patients had associated extra mural pancreatic pseudocysts. All patients had abdominal pain on presentation. Along with pain the patients with duodenal intramural pseduocysts also had symptoms suggestive of gastric outlet obstruction (3) or jaundice (1). The patient with esophageal intramural pseudocyst had dysphagia along with abdominal pain. Majority of these patients could be successfully treated endoscopically with no significant complications.Conclusions:Intramural pseudocysts of the upper GIT are very rare and EUS is a useful investigational modality for diagnosing and treating them.

Infected Pancreatic Hydatid Cyst with Cysto-Pancreatic Fistula Presenting as Acute Pancreatitis

“…4 EUS is a newer imaging modality that provides high-resolution images of the pancreas and is an important investigation procedure for diagnosis and evaluation of pancreatic cystic lesions. 5 Demonstration of daughter cysts and hydatid sand on EUS can help in the confident diagnosis of pancreatic hydatid disease, as was in the index case. EUS can also help in demonstrating the communication of PD with the cyst.…”

Endo-laparoscopic rendezvous approach for pericardia with gastric posterior wall of gastrointestinal stromal tumor: Analysis of 52 consecutive cases

“…Moreover, it ensures a sufficient tumor margin because the gastric wall is resected while confirming the especially helpful for preserving cardia. [12][13][14][15] Stenosis and deformation are prevented, even for an obstruction because the procedure can be performed for minimal resection. Our study, usually all perform this procedure for GISTs more than 2 cm away from esophageal gastric junction because this distance is necessary for a linear stapler to be used.…”

Pseudoquiste pancreático intramural gástrico en páncreas heterotópico, una causa infrecuente de retención gástrica. Caso clínico

“…Los pseudoquistes intramurales del tracto intestinal son de muy rara incidencia y el mecanismo exacto de su formación no es bien conocido. Los posibles mecanismos para su formación son rotura de un pseudoquiste pancreático dentro de la pared gastrointestinal, presencia de una fístula entre el páncreas y el tubo digestivo o inflamación de tejido pancreático heterotópico dentro de la pared gastrointestinal 4,5 .…”