Successful Management of a Pancreatic Pseudocyst by Endoscopic Drainage

Abstract

A 38-year-old man who was a heavy drinker was referred to our hospital due to abdominal pain. CT showed a pseudocyst in the head of the pancreas. ERCP performed via the ventral pancreatic ducts (PD) revealed the cystic cavity, and cyst drainage was performed. On injection of contrast material into the minor papilla, the dilated PD in the body and tail of the pancreas were visualized, and no communication with the ventral PD was evident. Pancreatic divisum was diagnosed on the basis of the pancreatography. A stent was placed in the cyst cavity via the major papilla, and a pancreatic stent was placed in the dilated main PD via the minor papilla. CT performed after 3 months revealed that the cyst had disappeared. Transpapillary drainage was considered a useful procedure for the management of PPC associated with alcoholic chronic pancreatitis accompanied by pancreatic divisum.