Conservative Management of a Large-sized Pancreatic Pseudocyst: A Case Report

Abstract

Background: The management of pancreatic pseudocyst involves several treatment options. Among them figure predominantly the surgical, endoscopic and percutaneous drainages. Conservative management is a therapeutic alternative especially for small sized pseudocysts. Larger cysts, more than 6 cm in diameter, are usually treated surgically. However, it had been reported some cases of large-sized pancreatic pseudocyst that had regressed spontaneously. It raises the question about the systematic treatment in large-sized pancreatic pseudocyst. Case presentation: A 55-year-old man who had a 40-year history of alcoholism and a medical history of acute pancreatitis 3 weeks prior to his presentation was sent for an abdominal exploration by CT scan. The CT scan showed a pancreatic pseudocyst of 13 cm in diameter. Meanwhile the patient was just complaining of epigastric pain that was well managed by analgesics. A conservative management was then decided. At the follow-up, CT scan was realized at the 1st, the 3rd and the 5th month. It showed a decreasing of the size of the cyst. Moreover, the CT scan done 3 years after the onset, showed a strictly normal pancreatic parenchyma. Conclusion: Conservative management is a feasible alternative therapy in large pancreatic pseudocysts, bearing in mind a rigorous clinical and radiological monitoring of the patient.