CT-guided drainage of a mediastinal pancreatic pseudocyst with a transhepatic transdiaphragmatic approach

We describe a mediastinal pancreatic pseudocyst treated with a catheter drainage placed under computed tomographic guidance using a newly applied approach. A needle was angled cephalad with the computed tomographic gantry tilt technique, and was inserted into the lowest portion of the cavity through the liver and through the diaphragm. The needle pathway was necessitated by the location of the pseudocyst cavity. The drainage alleviated completely the symptoms with no complications. The puncture technique should be an option for accessing mediastinal lesions percutaneously.