Abstract
Acute pancreatitis can be followed by a pancreatic pseudocyst which poses some problems of operative indication, its timing, and selection of operative procedure.
A 52-year-old woman was urgently admitted to the hospital because of intensive abdominal pain, and was diagnosed as acute pancreatitis. On the 37th day after conservative treatment was started, a huge pancreatic pseudocyst was found by CT. Further 50 days later, transgastric cystogastrostomy was carried out. CT performed on the 15th day after surgery revealed a disappearance of the pseudocyst. Endoscopic examination on the 36th postoperative day disclosed that the anastomosed site was completely closed. When we entertain a possible natural disappearance of such pseudocysts, conservative treatments should be selected first according to general rules for the treatment of acute pancreatitis. However, in cases which have the persistent cyst even after 6 week observation, operation should be indicated. The operative procedure is selected case by case, however, this procedure applied in this case is a safe method and can offer the early disappearance of the pseudocyst and closure of the anastomosed site. On operation it is important to open anastomosed site as large as possible and to make sure of hemostasis.
