A Case of Mediastinal Pacreatic Pseudocyst Treated with Octreotide

Park, Sang Heum; Kim, Sun Joo; Kim, Eun Joo; Lee, Moon Ho; Kim, Hong Soo; Chung, Il Kwun; Kim, Chul; Lee, Chul Woo

Abstract

Pancreatic pseudocyst is a common complication of acute pancreatitis, which may occur at any site of pancreas and extrapancreatic tissue. In mediastinal pseudocyst, the most common route of dissemination into the thorax is esophageal and aortic hiatus. Major treatment method for mediastinal pseudocyst is surgery, but there are some reported cases treated with octreotide, a somatostatin analogue. We have experienced a case of mediastinal pseudocyst treated with medical treatment including octreotide. A 52-year-old man came to our hospital with complaints of mild dyspnea and epigastric pain. Chest X-ray showed a right pleural effusion and amylase level in pleural fluid was 4,965 IU/L. CT revealed multiple cystic lesions in the posterior mediastinum along the distal esophagus, splenic hilum, pancreatic tail and retropancreatic space. Our impression was pancreatic pseudocyst with mediastinal extension and pancreatic pleural effusion. We managed this patient with octreotide and TPN (total parenteral nutrition). Complete remission of the mediastinal pseudocyst was achieved without any drainge procedure.