Pancreatic Pseudocysts in the Mediastinal Space: An Urban Legend?

  • Jerome Blanc Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland
  • Tanja Fusi-Schmidhauser Department of Internal Medicine, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland

Keywords

Chronic pancreatitis, mediastinal pancreatic pseudocysts, dyspnoea, trismus, mediastinitis

Abstract

Pancreatic pseudocysts are a frequent complication of chronic pancreatitis. Nonetheless, they seldom extend beyond the peripancreatic region. However, migration towards the mediastinum may cause heterogeneous and non-specific symptoms, such as dysphagia, chest pain and dyspnoea, which depend on the localization and extension of the cysts. We present the case of a patient with chronic pancreatitis who was admitted to our ward for low-grade fever and mild dyspnoea and who rapidly developed bilateral laterocervical swelling associated with acute dyspnoea and trismus. A total body CT scan showed multiple abdominal pancreatic pseudocysts, one of which had migrated to the mediastinum and towards the retropharyngeal space. Clinicians should always consider the possibility of extra-pancreatic pseudocysts in patients with known pancreatitis so that uncommon clinical presentations with a potentially fatal outcome will be recognized.

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  • Published: 2019-09-04

    Issue: Vol 6 No 9 (view)

    Section: Articles

    How to cite:
    Blanc, J., & Fusi-Schmidhauser, T. (2019). Pancreatic Pseudocysts in the Mediastinal Space: An Urban Legend?. European Journal of Case Reports in Internal Medicine, 6(9). https://doi.org/https://doi.org/10.12890/2019_001228