Huge pancreatic pseudocyst in a patient who suffered from myocardial infarction and a pancreatitis

Introduction: A 40-year old man patient suffered from acute pancreatitis. After a thorough examination we discovered a 18×12×12cm had developed pancreas pseudocyst.

Methods: We would like to present this pancreas pseudocyst and the leading of a pigtail catheter, which functioned as cystogastrostoma on video and CT pictures.

Results: A 40-year old patient – who has suffered from a myocardial infarction a year earlier – waiting for the coronarography he was admitted to our department with sharp epygastrial pains. For this reason, he took an acute hospital admission. In his anamnesis was a perforation of duodenal ulcer, and after that a sutura in surgery. The examination showed an acute pancreatitis and an anemia. His complains were regressed after a few days, when he got a 0 diet and infusion. We gave him a blood transfusion because of his anemia. We made a gastroscopy because of his anaemia, and found a very big soft consistent, cystic formula in the fornix. There was a 18×12×12cm big pancreas pseudocyst on the belly CT. It was suitable for an endoscopic cysto-gastrostoma. At first we performed an endoscopic cysto-gastrostoma with a pigtail catheter, and during the examination a 1 liter sanguinolent fluid evacuated (amylase: 22000E, htk 9%), after that the pigtail catheter remained there. The patient was without complaints. At present, 2,5-years after the intervention, there is not a pancreas pseudocyst on the CT any more.

Conclusion: In our practice the provision of such a very big-sized pancreas pseudocyst with the help of pigtail catheter it is rare – in the case of a high risk patient suffered from a myocardial infarction – after 2,5-years it proved to be a successful intervention.