Mediastinal Pseudocyst: Varied Presentations and Management—Experience from a Tertiary Referral Care Centre in India

Abstract

Pseudocysts are a recognised complication following acute or chronic pancreatitis. Usually located in peripancreatic areas, they have also been reported to occur in atypical regions like liver, pelvis, spleen, and mediastinum. Mediastinal pseudocysts are a rare entity and present with myriad of symptoms due to their unique location. They are a clinical challenge to diagnose and manage. In this paper, we describe the clinical and radiological characteristics of mediastinal pseudocysts in 7 of our patients, as well as our experience in managing these patients along with their clinical outcome.

Mediastinal Extension of Pancreatic Pseudocyst: A Rare Pediatric Presentation

“…These fistulae can be further subdivided into pancreaticopericardial, pancreaticopleural, pancreaticobronchial, or a mediastinal pseudocyst. [ 6 ]…”

Mediastinal Extension of a Pancreatic Pseudocyst: A Rare Intrathoracic Complication of Pancreatitis

“…Conventional peripancreatic pseudocysts typically present with abdominal pain, early satiety, nausea, vomiting, jaundice, and/or bleeding [Vitas and Sarr [ 9 ]]. Mediastinal pseudocysts, in contrast, usually lack the conventional pancreatic symptoms and instead have predominantly cardiopulmonary and upper GI findings including dysphagia, dyspnea, chest pain, and palpitations [Segamalai et al [ 10 ]]. More severe presentations include hemothorax, sepsis, acute airway obstruction, congestive heart failure, and cardiogenic shock [Ajmera and Judge [ 4 ]].…”

Pseudopancreatic Cyst Extending into the Mediastinum in a 7-Year-Old Child

“…14 Although ultrasound is accurate in diagnosing PP, it cannot detect the existing mediastinal extension. 15 Contrast-enhanced CT is a valuable modality not just in identifying the pseudocyst but also establishing its relationship with surrounding structures. It appears as a thin-walled low attenuation peripherally enhancing cyst.…”