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Mediastinal pancreatic pseudocyst in a child. A thoracoscopic approach
A Bonnard1, P Lagausie, S Malbezin
1Department of Pediatric Surgery, Hôpital Robert Debré, 48, boulevard Sérusier, 75020 Paris, France.
Insights
A rare mediastinal pancreatic pseudocyst in a child was successfully treated with a novel thoracoscopic approach. This minimally invasive technique offers a safe and effective alternative for managing pediatric mediastinal pseudocysts.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Thoracic Surgery
Background:
- Mediastinal pancreatic pseudocysts are rare in children, posing diagnostic and therapeutic challenges.
- Current treatments include cystenterostomy and external drainage, with varying success rates.
Observation:
- An 11-year-old boy presented with a mediastinal pseudocyst.
- The patient underwent a thoracoscopic procedure utilizing an original pulmonary exclusion technique.
Findings:
- The mediastinal pseudocyst resolved completely within 15 days post-procedure.
- No recurrence was observed, and no adjuvant treatments were required.
- Endoscopic retrograde cholangiopancreatography (ERCP) identified pancreas divisum as the etiology.
Implications:
- The thoracoscopic approach with pulmonary exclusion is a reproducible, simple, and safe treatment for pediatric mediastinal pseudocysts.
- This technique presents a viable alternative to traditional cystogastrostomy.
- Minimally invasive thoracic surgery can be effective for managing complex pediatric pancreatic fluid collections.
Abstract:
Mediastinal pancreatic pseudocyst is a rare occurrence in children and may be difficult to diagnose. Internal drainage via a cystenterostomy and a simple external drainage are two of the treatment options that are currently employed. We describe the case of an 11-year-old boy with a mediastinal pseudocyst who was treated via a thoracoscopic approach using an original pulmonary exclusion. The pseudocyst disappeared in 15 days and there has been no recurrence. No adjuvant treatment was necessary. Endoscopic retrograde cholangiopancreatography (ERCP) was useful in establishing the etiology (pancreas divisum). We believe that the thoracoscopic approach is a reproducible, simple, and safe procedure for the treatment of mediastinal pseudocysts. The technique may represent a valid alternative to cystogastrostomy.