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Un pseudokyste médiastinal avec fistule thoracopancréatique traité avec succès par drainage endoscopique transpapillaire

A mediastinal pseudocyst originating from a thoracopancreatic fistula successfully treated with endoscopic transpapillary drainage

  • Cas Clinique / Case Report
  • Published:
Acta Endoscopica

Résumé

Les pseudokystes pancréatiques médiastinaux sont rares mais représentent une complication potentiellement grave de la pancréatite aiguë. La rupture spontanée ainsi que la fistulisation peuvent survenir dans 3 % des cas. La prise en charge des pseudokystes médiastinaux demeure controversée et dépend essentiellement de leur localisation exacte, de leur étiologie, de l’anatomie canalaire ainsi que de l’expertise disponible. Toutefois, les interventions endoscopiques sont de plus en plus effectuées comme première modalité thérapeutique. Nous rapportons un cas de pseudokyste pancréatique avec extension médiastinale traité avec succès par voie endoscopique.

Abstract

Mediastinal pancreatic pseudocysts are rare but lifethreatening complications of pancreatitis. Rupture and fistulization occur in approximately three percent of cases. The management of mediastinal pseudocysts remains controversial and depends upon the exact location, etiology, ductal anatomy and expertise available. However, endoscopic interventions are increasingly used as the first modality of treatment. Here, we describe a case of mediastinal extension of a pancreatic pseudocyst successfully managed with endoscopic transpapillary drainage.

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Références

  1. Gentry SE, Harris MA. Posterior mediastinal mass in a patient with chest pain. Chest 1995;107:1757–1759.

    Article  PubMed  CAS  Google Scholar 

  2. Zeilender S, Turner MA, Glauser FL. Mediastinal pseudocyst associated with chronic pleural effusions. Chest 1990;97:1014–1016.

    Article  PubMed  CAS  Google Scholar 

  3. Le Roux BT, Kallichurum S, Shama DM. Mediastinal cysts and tumors. Curr Probl Surg 1984;21:1–77.

    PubMed  Google Scholar 

  4. Casson AG, Inculet R. Pancreatic pseudocyst. An uncommon mediastinal mass. Chest 1990;98:717–718.

    Article  PubMed  CAS  Google Scholar 

  5. Rose EA, Haider M, Yang SK, Telmos AJ. Mediastinal extension of pancreatic pseudocyst. Am J Gastroenterol. 2000;95:3638–3639.

    Article  PubMed  CAS  Google Scholar 

  6. Lillemore KD, Yeo CJ. Management of complications of pancreatitis. Curr Probl Surg 1998;35:1–98.

    Google Scholar 

  7. Vosoghi M, Sial S, Garrett B, Feng J, Lee T, Stabile BE, et al. EUS-guided pancreatic pseudocyst drainage: review and experience at Harbor-UCLA Medical Center. Med Gen Med 2002;4:2.

    Article  Google Scholar 

  8. Ajmera AV, Judge TA. Mediastinal extension of pancreatic pseudocyst-a case with review of topic and management guidelines. Am J Ther 2012;19:e152–e156

    Article  PubMed  Google Scholar 

  9. Grace PA, Williamson RC. Modern management of pancreatic pseudocysts. Br J Surg 1993;80:573–581.

    Article  PubMed  CAS  Google Scholar 

  10. Gedgaudas-McClees RK, Torres WE, Colvin RS, McClees EC, Baron MG. Thoracic findings in gastrointestinal pathology. Radiol Clin North Am 1984;22:563–589.

    PubMed  CAS  Google Scholar 

  11. Jaffe BM, Ferguson TB, Holtz S, Shields JB. Mediastinal pancreatic pseudocysts. Am J Surg 1972;124:600–606.

    Article  PubMed  CAS  Google Scholar 

  12. Pitchumoni CS, Agarwal N. Pancreatic pseudocysts: when and how should drainage be performed? Gastroenterol Clin North Am 1999;28:615–639.

    Article  PubMed  CAS  Google Scholar 

  13. Winton TL, Birchard R, Nguyen KT, Taguchi K. Esophageal obstruction secondary to a mediastinal pancreatic pseudocyst. Can J Surg 1986;29:376–377.

    PubMed  CAS  Google Scholar 

  14. Lee FY, Wang YT, Poh SC. Congestive heart failure due to a pancreatic pseudocyst. Cleve Clin J Med 1994;61:141–143.

    PubMed  CAS  Google Scholar 

  15. Landrenau RJ, Johnson JA, Keenan RJ, Thompson WM, Megison S, Ferson PF. “Spontaneous” mediastinal pancreatic pseudocyst fistulization to the esophagus. Ann Thor Surg 1994;57:208–210.

    Article  Google Scholar 

  16. Frenzer A, Schubarth P, Soucek M, Krähenbühl S. Disappearance of a large mediastinal pseudocyst in a patient with chronic alcoholic pancreatitis after total parenteral nutrition. Eur J Gastroenterol Hepatol 1995;7:369–371.

    PubMed  CAS  Google Scholar 

  17. Santoshkumar S, Seith A, Rastogi R, Khilnani GC. Mediastinal pseudocysts in chronic pancreatitis with spontaneous resolution. Trop Gastroenterol 2007;28:32–34.

    PubMed  CAS  Google Scholar 

  18. Suga H, Tsuruta O, Okabe Y, Saitoh F, Noda T, Yoshida H, et al. A case of mediastinal pancreatic pseudocyst successfully treated with somatostatin analogue. Kurume Med J 2005;52:161–164.

    Article  PubMed  Google Scholar 

  19. Mallavarapu R, Habib TH, Elton E, Goldberg MJ. Resolution of mediastinal pancreatic pseudocysts with transpapillary stent placement. Gastrointest Endosc 2001;53:367–370.

    PubMed  CAS  Google Scholar 

  20. Kim DJ, Chung HW, Gham CW, Na HG, Park SW, Lee SH et al. A case of complete resolution of mediastinal pseudocyst and pleural effusion by endoscopic stenting of pancreatic duct. Yonsei Med J 2003;44:727–731.

    PubMed  Google Scholar 

  21. Bhasin DK, Rana SS, Nanda M, Chandail VS, Masoodi I, Kang M, et al. Endoscopic management of pancreatic pseudocysts at atypical locations. Surg Endosc 2010;24:1085–1091.

    Article  PubMed  Google Scholar 

  22. Chettupuzha AP, Harikumar R, Kumar SK, Thomas V, Devi SR. Pancreatic pseudocyst presenting as odynophagia. Indian J Gastroenterol 2004;23:27–28.

    PubMed  Google Scholar 

  23. Gupta R, Munoz JC, Garg P, Masri G, Nahman NS, Lambiase LR. Mediastinal pancreatic pseudocyst-a case report and review of the literature. Med Gen Med 2007;9:8.

    Google Scholar 

  24. Saftoiu A, Ciurea T, Dumitrescu D, Stoica Z. Endoscopic ultrasound-guided transesophageal drainage of a mediastinal pancreatic pseudocyst. Endoscopy 2006;38:538–539.

    Article  PubMed  CAS  Google Scholar 

  25. Mohl W, Moser C, Kramann B, Zeuzem S, Stallmach A. Endoscopic transhiatal drainage of a mediastinal pancreatic pseudocyst. Endoscopy 2004;36:467.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Département de médecine, service de gastroentérologie, centre hospitalier universitaire de Sherbrooke, 580 Bowen Sud, Sherbrooke, QC, Canada, J1G 2E8

    J. Ruel & G. Rateb

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  1. J. Ruel
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  2. G. Rateb
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Correspondence to J. Ruel.

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Ruel, J., Rateb, G. Un pseudokyste médiastinal avec fistule thoracopancréatique traité avec succès par drainage endoscopique transpapillaire. Acta Endosc 43, 175–179 (2013). https://doi.org/10.1007/s10190-013-0333-1

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  • DOI: https://doi.org/10.1007/s10190-013-0333-1

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