PSEUDO-KYSTE DU PANCREAS CHEZ LA PERSONNE AGEE

Abstract

Introduction: Pancreatic pseudocysts (PKP) are fluid collections without their own epithelium, developed at the expense of or in contact with the pancreas, containing pure pancreatic juice or mixed with necrotic debris, following pancreatitis or trauma, or of undetermined cause. Treatment of PKP usually requires drainage. We discuss the diagnostic and therapeutic aspects of a case of pseudocyst of the pancreas drained by conventional surgery in an elderly patient with a good post-operative course. Observation: We admitted an 80-years-old patient with epigastric abdominal mass, pain, physical asthenia and anorexia evolving for 1 year. She had no previous medical history. Examination revealed a painful epigastric abdominal mass, more or less mobile in relation to the deep plane, with a smooth surface and irregular, matt edges. Pelvic touch was unremarkable. CT scan showed a large intra-abdominal cystic mass (pancreatic cyst? mesenteric cyst?). Biology revealed anemia and hyperleukocytosis. After laparotomy, we found a voluminous, firm cystic mass, about 10x5x8 cm in size, at the expense of the body of the pancreas. We proceeded to internal drainage of the cyst by retrogastric cysto gastrostomy according to JEDLICKA. The patient was followed up for one year without any particularities. Conclusion: In our case, a symptomatic pancreatic pseudocyst was drained by surgical retrogastric cystogastrostomy with a favorable outcome. The management of pancreatic pseudocysts requires a multidisciplinary approach and an adequate technical platform.