Pancreatic Pseudocyst Following Spinal Surgery: Always Think About It-A Case Report

To report the conservative management of a pancreatic pseudocyst (PP) following spinal surgery for neurogenic scoliosis in a pediatric patient.

A 12-years-old girl presented with spinal arthrodesis and lumbar fixation for neurogenic scoliosis secondary to cerebral palsy (CP). On postoperative day 11, abdominal computed tomography (CT) showed accumulated fluid (74 × 52 mm) extending along the greater gastric curvature, from the left liver lobe to the anterior abdominal wall.

The fluid was percutaneously drained. The fluid contained a high concentration of amylase; therefore, a diagnosis of PP was made. After 23 days, the symptoms progressively resolved, and the accumulated fluid disappeared. Gastrointestinal complications following spinal surgery in patients with CP are reported in 5%-55% of cases; among these, PP is extremely rare. Pancreatic postoperative ischemia or pancreatic iatrogenic trauma are possible causes of PP formation. In our case, conservative management was safe and effective.

In patients with persistent postoperative abdominal symptoms following spinal surgery, pancreatic complications should be ruled out. If PP is diagnosed, conservative management is recommended, particularly in young patients with a poor general condition.