Abstract | May 7, 2021

Massive Pseudo-Pneumoperitoneum after drainage of Pancreatic Pseudocyst

Presenting Author: Maria Goretti S Ochi, MD, Internal Medicine Resident PGY2, Department of Medicine, Dell Seton Medical Center, Austin, TX

Coauthors: Deepak Agrawal, MD, MPH, Chief of Gastroenterology & Hepatology, Department of Medicine, Division of Gastroenterology, Dell Seton Medical Center, Austin, TX

Learning Objectives

  1. Be able to know and identify a pancreatic pseudocyst;
  2. How to manage pancreatic pseudocysts;
  3. Complications that can arise with the draining pseudocyst.

Pancreatic pseudocyst is a complication of acute or chronic pancreatitis. Most resolve spontaneously but symptomatic pseudocysts need to be drained. The preferred therapeutic management is endoscopic ultrasound (EUS) guided drainage with stent placement. Herein, we describe a patient that presented with symptomatic pseudocyst after idiopathic necrotizing pancreatitis. EUS-guided drainage and stent placement was performed.

Afterwards, pneumoperitoneum was noted on imaging. Patient was stable but given the size of the pneumoperitoneum on imaging, an emergent diagnostic laparoscopy was performed. However, surgical evaluation showed no perforation or pancreatic fluid contamination. Patient was discharged 2 days later in stable condition. At 3-month follow up, patient was doing well and awaiting plastic stents removal.

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