A rare case of mediastinal pseudocyst in patient after acute pancreatitis

Czech version

Authors: P. Koželský; D. Hoskovec; J. Ulrych; Z. Krška
Authors‘ workplace: 1. LF UK a VFN v Praze ; I. chirurgická klinika – břišní, hrudní a úrazové chirurgie
Published in: Rozhl. Chir., 2025, roč. 104, č. 4, s. 146-148.
Category: Case Report
doi: https://doi.org/10.48095/ccrvch2025146

Overview

Acute pancreatitis may present with a variety of complications, the whole range of thoracic complications is presented as the rare enzymatic ascending mediastinitis as well as rare mediastinal pseudocysts. The mortality rate of mediastinal complications is high, 14–47%. Due to the small number of described cases, no clear recommendations have been made regarding the treatment of mediastinal pseudocyst. From the documented cases, spontaneous regression of mediastinal pseudocysts is rare and the clear benefit is reached by endoscopic treatment. Surgical therapy should be indicated only in case of failure of pharmacotherapy or endoscopic treatment. The differential diagnosis of the patient’s difficulties after pancreatitis includes a whole range of polymorphic manifestations. However, as we illustrate in this case report, we should not forget them, especially because of the mortality rate.

Keywords:

case report – acute panctreatitis – mediastinal pseudocysts

Sources

1. Ulrych J. Akutní pankreatitida. In: Krška Z (ed). Albertova sbírka. Onemocnění slinivky břišní. Praha: We Make Media 2019: 53–109.

2. Beger HG, Rau B, Mayer J et al. Natural course of acute pancreatitis. World J Surg 1997; 21(2): 130–135. doi: 10.1007/s002689900204.

3. Banks PA, Bollen TL, Dervenis C et al. Classification of acute pancreatitis – 2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62(1): 102–111. doi: 10.1136/gutjnl-2012-302779.

4. Basran GS, Ramasubramanian R, Verma R. Intrathoracic complications of acute pancreatitis. Br J Dis Chest 1987; 81(4): 326–331. doi: 10.1016/0007-0971(87)90180-x.

5. Kumar P, Gupta P, Rana S. Thoracic complications of pancreatitis. JGH Open 2018; 3(1): 71–79. doi: 10.1002/jgh3.12099.

6. Zaitsu Y, Nishizaki T, Izumi T et al. Pancreatic enzymatic mediastinitis followed by total gastrectomy with splenectomy: report of two cases. Surg Case Rep 2021; 7(1): 149. doi: 10.1186/s40792-021-01240-5.

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Article was published in

Perspectives in Surgery

2025 Issue 4

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