A 60 year-old-man was refered to our hospital complaining upper abdominal pain and pyrexia. Pancreatic pseudocyst had been noted in the region of the tail since Hassab operation was performed for esophageal varices 7 years ago. CT revealed remarkable increasing of the size of the cyst. Endoscopic examination showed no bulge in the stomach. Firstly, nasocystic dorainage was performed. 19G needle was passed into the cyst under EUS guidance. After guide wire was inserted through the needle, nasocystic tube was placed. Although the 3rd day CT revealed the pseudocyst reduced in size, the patients removed nasocystic tube by himself. Then cystgastrostomy was performed. After the cyst was punctured under EUS gidance, the site was dilated with balloon under duodenoscope. Then an endoprosthesis was placed. After the procedure, CT revealed disappearance of pseudocysts and the patient became free of symptoms. Endoscopic ultrasonography guided drainage was safer and more effective procedure for the treatment of pancreatic pseudocyst.
