EURORAD ESR

Case 2795

Percutaneous psuedocystogastrostomy in a patient with three large pseudocysts: A simple technique to obtain a permanent internal drainage

Author(s)
Sedati P, Paciucci L, Pelle G, Sandolo F, Macrì F
 
Patient
male, 56 year(s)
 
 
  • Figure 1
    h-CT demonstrating the presence of three fluid collections in the peripancreatic area, adjacent...
     

    A CT scan demonstrating the presence of three fluid collections (60 mm in maximum diameter) in the peripancreatic area, adjacent to the stomach. The walls of the cysts are well depicted after an injection of contrast...

     
    Area of Interest: unknown; Imaging Technique: Fig 1a-b-c h-CT demonstrates the presence of three fluid collections in the peripancreatic area, adjacent to the stomach;

    A h-CT scan demonstrating the presence of three fluid collections (60 mm in maximum diameter) in the peripancreatic area, adjacent to the stomach. The cystic walls are well demarcated after the injection of contrast...

     
    Area of Interest: unknown; Imaging Technique: Fig 1a-b-c h-CT demonstrates the presence of three fluid collections in the peripancreatic area, adjacent to the stomach;

    A h-CT scan demonstrating the presence of three fluid collections (60 mm in maximum diameter) in the peripancreatic area, adjacent to the stomach. The cysts walls are well demarcated after the injection of a contrast...

     
    Area of Interest: unknown; Imaging Technique: Fig 1a-b-c h-CT demonstrates the presence of three fluid collections in the peripancreatic area, adjacent to the stomach;
     
     
  • Figure 2
    The puncture of the cyst located in the pancreatic tail, under CT guidance.
     

    An image depicting the percutaneous approaches for percutaneousl pseudocyst drainage.

     
    Area of Interest: unknown; Imaging Technique: Puncture of the cyst located in the tail under CT guidance.;

    An image showing the puncture of the cyst located around the pancreatic tail, under CT guidance. The anterior and posterior gastric walls are traversed by the catheter.

     
    Area of Interest: unknown; Imaging Technique: Puncture of the cyst located in the tail under CT guidance.;

    An image depicting the puncture of the cyst located in the pancreatic tail, under CT guidance. The anterior and posterior gastric walls are traversed.

     
    Area of Interest: unknown; Imaging Technique: Puncture of the cyst located in the tail under CT guidance.;
     
     
  • Figure 3
    Pseudocystogastrostomy procedure
     

    An image obtained after the placement of a 10 F catheter and six days of external drainage showing the two cyst that located in the body and the head have been opacified. Note that there is no residual cystic cavity...

     
    Area of Interest: unknown; Imaging Technique: Pseudocystogastrostomy procedure;

    An image obtained after the placement of a 10 F catheter and six days of external drainage, showing that the two cysts located in the body and the head are opacified. Note that there is no residual cystic cavity and...

     
    Area of Interest: unknown; Imaging Technique: Pseudocystogastrostomy procedure;

    An image showing the proximal end of the catheter pushed over a guide-wire and inserted deeply into the stomach.

     
    Area of Interest: unknown; Imaging Technique: Pseudocystogastrostomy procedure;

    A lateral X-ray confirming the correct position of the proximal end of the catheter inside the stomach.

     
    Area of Interest: unknown; Imaging Technique: Pseudocystogastrostomy procedure;

    An image obtained after placement, showing the cut ends of the stent within the cavity of the stomach.

     
    Area of Interest: unknown; Imaging Technique: Pseudocystogastrostomy procedure;

    An image obtained of upper-GI series with a water soluble iodinated agent showing that there are no gastric leaks and that the stents are well in place.

     
    Area of Interest: unknown; Imaging Technique: Pseudocystogastrostomy procedure;
     
     
  • Figure 4
    A h-CT, one week after the procedure

    A CT image obtained one week after the procedure confirming the correct position of the catheter inside the stomach. Note that the cysts contain air and that there is no reaccumulation of fluid within the cavity,...

     
    Area of Interest: unknown; Imaging Technique: h-CT one week after the procedure;
     
     
  • Figure 5
    A control h-CT performed after six months
     

    A CT scan performed six months after catheter drainage demonstrating the complete resolution of the pseudocysts, without recurrence.

     
    Area of Interest: unknown; Imaging Technique: Control h-CT performed after 6 months;

    A control h-CT scan performed after six months demonstrating the complete resolution of the pseudocysts, without recurrence.

     
    Area of Interest: unknown; Imaging Technique: Control h-CT performed after 6 months;

    A control h-CT scan performed after six months demonstrating the complete resolution of the pseudocysts, without recurrence.

     
    Area of Interest: unknown; Imaging Technique: Control h-CT performed after 6 months;
     
     
A CT scan demonstrating the presence of three fluid collections (60 mm in maximum diameter) in the peripancreatic area, adjacent to the stomach. The walls of the cysts are well depicted after an injection of contrast medium, indicating a mature pseudocyst.
 
A h-CT scan demonstrating the presence of three fluid collections (60 mm in maximum diameter) in the peripancreatic area, adjacent to the stomach. The cystic walls are well demarcated after the injection of contrast medium and this indicates a mature pseudocyst.
 
A h-CT scan demonstrating the presence of three fluid collections (60 mm in maximum diameter) in the peripancreatic area, adjacent to the stomach. The cysts walls are well demarcated after the injection of a contrast medium and this indicates a mature pseudocyst.
 
An image depicting the percutaneous approaches for percutaneousl pseudocyst drainage.
 
An image showing the puncture of the cyst located around the pancreatic tail, under CT guidance. The anterior and posterior gastric walls are traversed by the catheter.
 
An image depicting the puncture of the cyst located in the pancreatic tail, under CT guidance. The anterior and posterior gastric walls are traversed.
 
An image obtained after the placement of a 10 F catheter and six days of external drainage showing the two cyst that located in the body and the head have been opacified. Note that there is no residual cystic cavity and that both cysts communicate with the pancreatic ductal system. The arrow indicates the point where the 10 F catheter was cut.
 
An image obtained after the placement of a 10 F catheter and six days of external drainage, showing that the two cysts located in the body and the head are opacified. Note that there is no residual cystic cavity and that both cysts communicate with the pancreatic ductal system. The arrow indicates the point where the 10 F catheter was cut.
 
An image showing the proximal end of the catheter pushed over a guide-wire and inserted deeply into the stomach.
 
A lateral X-ray confirming the correct position of the proximal end of the catheter inside the stomach.
 
An image obtained after placement, showing the cut ends of the stent within the cavity of the stomach.
 
An image obtained of upper-GI series with a water soluble iodinated agent showing that there are no gastric leaks and that the stents are well in place.
 
A CT image obtained one week after the procedure confirming the correct position of the catheter inside the stomach. Note that the cysts contain air and that there is no reaccumulation of fluid within the cavity, indicating a good outcome of the pseudocystogastrostomy procedure.
 
A CT scan performed six months after catheter drainage demonstrating the complete resolution of the pseudocysts, without recurrence.
 
A control h-CT scan performed after six months demonstrating the complete resolution of the pseudocysts, without recurrence.
 
A control h-CT scan performed after six months demonstrating the complete resolution of the pseudocysts, without recurrence.
 
 
 
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