Spontaneous internal drainage of a pancreatic pseudocyst: a case report

A 72 year old patient was admitted to our department with progressive abdominal symptoms caused by chronic pancreatitis. Physical examination and laboratory data were unremarkable, ultrasound showed a cystic lesion beneath the pancreatic head. Initial endoscopic examination demonstrated a duodenal stenosis; in the second examination the stenosis had resolved by spontaneous perforation of the pseudocyst into the duodenal bulb. Pancreatic and peri-pancreatic pseudocysts are common in acute and chronic pancreatitis; the frequency of their diagnosis increased following the advent of ultrasonography and computed tomography as diagnostic tools and more intensive clinical monitoring. Our knowledge about the incidental course of the disease is still limited. When the diagnosis is established, a lot of questions referring to the choice of therapeutic regime-conservative treatment, percutaneous intervention, endoscopic or surgical procedures arise. Therapeutic possibilities and their advantages are discussed.