Three cases of mediastinal pancreatic pseudocysts

Abstract

A rare complication of acute or chronic pancreatitis is the formation of a mediastinal pancreatic pseudocyst (MPP), which is caused by tracking of pancreatic fluids through anatomical openings of the diaphragm into the mediastinum. Herein, we report the imaging characteristics of three cases of this condition. Our results revealed three features in common: (i) the connection between the mediastinum and the pancreatic cystic lesion; (ii) the presence of pleural effusions; and (iii) imaging findings consistent with chronic pancreatitis, such as pancreatic atrophy and calcifications and dilatation and/or stricture of main pancreatic duct (MPD). Serial diameter changes of the MPD and of the adjacent pseudocysts were necessary for the determination of the therapeutic strategy used in each case.

Thoracic complications of pancreatitis

“…Communication with the peripancreatic collection can also be demonstrated in some cases. Air may be seen in the case of infected collections . MRI with MRCP can demonstrate fistulous communications with the pancreatic duct or the peripancreatic collections.…”

“…Air may be seen in the case of infected collections. [73][74][75] MRI with MRCP can demonstrate fistulous communications with the pancreatic duct or the peripancreatic collections. In addition, ductal morphology, such as disruption, communication with pseudocyst, stricture, and dilatation, are best defined by MRCP.…”

Pancreatic Pseudocyst with Mediastinal Extension Presenting as Pseudo-Kirklin Sign—Multimodality Imaging

“…It is believed that mediastinal pseudocysts are caused by pancreatic fluid riding up through the diaphragmatic openings, especially the esophageal and aortic openings being the most common entry sites into the posterior mediastinum. 6 This is believed to be due to rupture of the pancreatic duct posteriorly into the retroperitoneal space. Pancreatic pseudocyst symptoms typically include abdominal pain with tenderness, diarrhea, fever, ascites, nausea and vomiting, weight loss, and jaundice.…”

Nonneoplastic lesions of the pancreas: retrospective analysis of 20 cases

“…Psödokistler; akut veya kronik pankreatit, travma ve nadiren de büyük duktusların neoplastik tıkanmasıyla ilişkili, non-epitelyal kistik lezyonlardır. [21,22] Erkeklerde daha sık görülür ve yaş ortalaması değişkendir. [23] Mikroskopik olarak psödokist duvarı non-epitelize granülasyon dokusu veya fibrotik dokudan oluşmaktadır (Şekil 6).…”