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Successful endoscopic drainage of a pancreatic pseudocyst in a 17-month-old boy
Laure Bridoux-Henno1, Alain Dabadie, Marc Rambeau
1Child and Adolescent Medicine Unit, CHR Hôpital Sud, Rennes, France. laure_bridoux@yahoo.fr
Insights
Endoscopic drainage is a safe and effective treatment for pediatric pancreatic pseudocysts (PPCs), offering similar outcomes to surgery with reduced complications. This minimally invasive approach shows promise for managing PPCs in children.
Area of Science:
- Pediatric Gastroenterology
- Minimally Invasive Procedures
Background:
- Pancreatic pseudocysts (PPCs) are a complication of acute pancreatitis in children.
- Drainage is necessary for PPCs causing symptoms or failing to resolve spontaneously.
Observation:
- A case of successful endoscopic drainage of an 8 cm PPC in a 17-month-old boy is presented.
- The procedure involved transgastric insertion of a nasobiliary catheter under endoscopic guidance.
Findings:
- The PPC resolved completely, with the child remaining asymptomatic and without abnormalities 18 months post-procedure.
- Endoscopic drainage demonstrated comparable efficacy and recurrence rates to surgery, with significantly lower morbidity.
Implications:
- Endoscopic drainage is an underutilized yet effective treatment option for pediatric PPCs.
- This technique offers a less invasive alternative to surgery for managing symptomatic PPCs in children.
Unlabelled:
Pancreatic pseudocysts (PPCs) develop in 10% to 30% of children with acute pancreatitis. PPCs that impinge on neighbouring structures, cause pain, or fail to undergo spontaneous resolution must be drained. Surgery and percutaneous aspiration are the most widely used techniques for draining PPCs. We successfully performed an endoscopic drainage in a 17-month-old boy. A nasobiliary catheter was inserted via the gastric wall under endoscopic guidance to drain an 8 cm PPC of unknown origin responsible for pain, ascites, and displacement of the stomach with vomiting. The cyst collapsed. Eighteen months later, the child had no symptoms or abnormalities by laboratory testing or ultrasonography. Whereas endoscopic drainage is widely used to treat PPC in adults, only five paediatric cases have been published.
Conclusion:
as compared to surgery, endoscopic drainage has provided similar efficacy and recurrence rates, with less morbidity.
