Ajay Singh, 45 year old male patient came to Endoscopy Asia with pain in abdomen since one and half months. He complained of loss of appetite and weight. On physical examination, a large lump was felt on the abdomen.
Past Medical History of patient revealed that the patient had severe pancreatic inflammation one year back, for which he was operated through a large midline incision. Patient subsequently developed hernia at the incision site for which was again operated upon.
Patient had gone through several imaging studies (CT scan-abdomen, USG-Abdomen) which revealed a large fluid filled sac behind the stomach. Patient consulted several surgeons for the treatment, but they were reluctant to operate in view of history of multiple surgeries in the past.
Endoscopy Asia’s Intervention
- Diagnosis: Patient was evaluated with endoscopic ultrasound and the size of the fluid collection was determined as 14 cm X 11 cm. On colour Doppler it was confirmed that it is not connected to any vascular structure. A diagnosis of Large Pancreatic Pseudocyst was reached upon.
- Treatment: Patient was operated by Endoscopy to drain the fluid collection. The procedure was done in twenty minutes without any complications and almost 2 litres of fluid was drained.
- Prognosis of the patient: The patient’s symptoms were revealed within three hours of the procedure. He resumed work after three days of surgery.
The case became complicated due to multiple scars of previous surgeries, resultant intra-abdominal adhesions and large size of the fluid. Endoscopic Ultrasound guided Endoscopic cystogastrostomy performed at Endoscopy Asia has been the standard practice at the centre since last 13 years. The safety of the procedures performed at Endoscopy Asia is ensured due to vast experience and expertise of the doctors at the centre.
Photographs
of the procedure:
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| Unilocular
Pancreatic pseudocyst |
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| Double
pigtail 10fr stent in situ |
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| Fluoroscopy
showing 10fr stent in situ |
