Mishra Sushil Kumar, Jain Pawan Kumar, Gupta Sukhdev
Gastroenterologist.
HOD Radiology.
J Assoc Physicians India. 2016 Mar;64(3):80-81.
Pseudocyst is a common complication of Acute and chronic pancreatitis. However, its extension into the mediastinum is a rare entity. We present a case of 52 years male with acute on chronic pancreatitis (alcohol related) who presented with dysphagia and dyspnoea and was found to have a pancreatic pseudocyst extending upto the neck. Ultrasound fails to pick up mediastinal pseudocysts and requires additional imaging modalities - CT and MRI. Management of Mediastinal pseudocyst depends upon underlying etiology, ductal anatomy, size of the pseudocyst, and availability of expertise. Small pseudocysts in asymptomatic patients may resolve spontaneously, but requires prolonged conservative therapy with somatostatin or its analogue and Total Parenteral Nutrition. Ruptured pseudocyst in a symptomatic unstable patient requires surgical resection. Endoscopic ultrasound guided drainage (transmural or transpapillary) and Main Pancreatic Duct stenting are safe and effective treatment modality.
胰腺假性囊肿是急慢性胰腺炎的常见并发症。然而，其延伸至纵隔是一种罕见情况。我们报告一例52岁男性，患有酒精相关的慢性胰腺炎急性发作，出现吞咽困难和呼吸困难，经检查发现胰腺假性囊肿延伸至颈部。超声无法检测到纵隔假性囊肿，需要借助CT和MRI等其他成像方式。纵隔假性囊肿的治疗取决于潜在病因、导管解剖结构、假性囊肿大小以及专业技术的可及性。无症状患者的小假性囊肿可能会自行消退，但需要使用生长抑素或其类似物进行长期保守治疗，并给予全胃肠外营养。有症状的不稳定患者出现破裂的假性囊肿需要手术切除。内镜超声引导下引流（经壁或经乳头）和主胰管支架置入是安全有效的治疗方式。
