Tratamiento de pseudoquiste pancreático con drenaje transpapilar por vía endoscópica: reporte de caso / Case report: treatment of pancreatic pseudocysts with endoscopic transpapillary drainage

Reportamos el caso de un paciente con pseudoquiste pancreático como complicación de un episodio de pancreatitis aguda, el cual se manifestó con dolor abdominal epigástrico, vómito y sensación de plenitud posprandial. El paciente no presentó mejoría clínica después de realizar manejo expectante durante más de 12 meses y en el seguimiento con tomografías de abdomen se evidenció persistencia de la lesión con aumento en el tamaño hasta 4 cm de diámetro mayor. El paciente fue remitido para manejo a nuestra institución. En imagen de colangiopancreatografía por resonancia magnética se encontró que el pseudoquiste estaba comunicado con el ducto pancreático proximal. Se realizó manejo endoscópico con drenaje por vía transpapilar con inserción de stent pancreático, el cual fue realizado con resultado exitoso, observando desaparición de la lesión a los 30 días después del drenaje sin recurrencia de los síntomas a los 60 días de seguimiento.

We report on the case of a patient with pancreatic pseudocysts. They presented as complications of an episode of acute pancreatitis which had manifested as epigastric pain, vomiting, and a postprandial sensation of fullness. After 12 months of watchful waiting the patient had not improved. Instead, an abdominal CAT scans revealed that the lesion persisted and had grown an additional 4 cm in diameter. The patient was referred to our institution for treatment. A magnetic resonance cholangiopancreatography (MRCP) image revealed that the pseudocyst passed through the proximal pancreatic duct. Endoscopic transpapillary drainage was successfully performed with the insertion of a pancreatic stent. The lesion had disappeared 30 days after drainage. Symptoms had not recurred 60 days after drainage.

A Case of Pancreatic Pseudocyst Resolved by Transpapillary Drainage via the Main Pancreatic Duct / 대한소화기내시경학회지

A 68-year-old man was admitted due to abdominal pain. He was diagnosed as having recurrent pancreatitis with a pseudocyst, which is communicated through the main pan- creatic duct. An endoscopic pancreatic sphincterotomy and insertion of a nasopancreatic tube into the main pancreatic duct via transpapillary drainage were performed. As a result, the pseudocyst disappeared and the pain was relieved. Thus it was concluded that transpapillary drainage via the main pancreatic duct is a safe and effective treatment for pancreatic pseudocysts, which is communicated through the main pancreatic duct.