Mediastinal pancreatic pseudocysts in children

Percutaneous retropleural drainage of a posttraumatic pancreatic mediastinal pseudocyst in a child

“…Mediastinal pseudocyst typically presents in children, such as in our patient, with abdominal pain, anorexia, vomiting, and dysphagia [3,6]. However, respiratory distress and dyspnea have also been reported [2,7].…”

“…The pancreatic secretions then gain access to the mediastinum most commonly through the esophageal hiatus, although extension through the aortic hiatus or direct erosion through the diaphragm has been reported [3]. In our patient, it is possible that the pseudocyst tracked through the aortic hiatus because this was not explored during the negative laparotomy.…”

“…These pancreatic pseudocysts are usually located in the retroperitoneum adjacent to the pancreas. Although extension into the mediastinum is well described in adults [1], only 9 cases of pancreatic mediastinal pseudocysts have been reported in children [2][3][4][5][6]. We report the case of a child with mediastinal pseudocyst secondary to pancreatic trauma, which was successfully treated with computed tomography (CT)-guided percutaneous drainage via a posterior, extrapleural approach.…”

Surgical management of a pancreaticopleural fistula in a child with chronic pancreatitis

“…In 6 of the patients, an obvious cause for the pancreatitis (as was the case with our patient) was not elucidated, and in the seventh, hereditary pancreatitis was identified as the primary etiologic factor. It has been postulated that a pancreatopleural fistula can arise because of ductal (pancreatic) disruption, particularly in its posterior aspect [2]; once in the retroperitoneum, the pancreatic fluid will move along the path of least resistance, which is usually along the esophagus or aorta and into the mediastinum [5]. In this region, the fistula may be contained and present as a mediastinal pseudocyst, or more commonly, it may erode into one or both pleural spaces resulting in pleural effusions.…”

Acute prevertebral abscess secondary to infected pancreatic pseudocyst

“…Immunosuppression due to diabetes mellitus, chemotherapy, renal failure and steroid therapy are other important predisposing factors in the development of deep neck space abscess 6–11. In the literature, there have been reports of extension of pseudocyst complicating an acute or chronic pancreatitis into the mediastinum, through the openings in the diaphragm, both in the adult and paediatric age groups; however, presence of a prevertebral abscess secondary to an infected pancreatic pseudocyst as a complication of pancreatitis in a diabetic patient has not been reported 12 13…”