Laparoscopic retrieval of a missing pancreatic pseudocyst drain

A 20-year woman who presented with acute pancreatitis developed a pseudocyst that was successfully drained by endoscopic placement of a stent as a cystogastrostomy. The first stent used went fully into the cyst and was irretrievable. Two years later a computed tomography showed the stent lying anterior to the left kidney. The stent was later successfully retrieved using a retroperitoneal laparoscopic approach, with the help of an image intensifier. Although high technical success rates of endoscopic drainage of pseudocysts are reported complications have been described including hemorrhage, secondary infection, and stent migration. We believe this is the first case described where a pseudocyst drain has migrated into the retroperitoneum and then been retrieved laparoscopically.