A rare case of giant pseudocyst of pancreas extending up to anterior abdominal wall requiring Roux en Y cystojejunostomy

Suresh G., Ramchandar Ramanan, Sureshkumar Ayyappan


Pancreatic pseudocyst is rather a common complication following pancreatitis and chronic alcoholism related. Only few cases of giant pseudocyst measuring more than 10 cm of size or more in widest diameter has been reported in the literature. Possible attributable factors for less reported cases may be due to discripancies in sizing classification, in several studies the term 'large' or 'huge' were used instead of 'giant' when cyst measuring 10 cm or larger in its widest diameter. Pancreatic pseudocyst is usually sterile but when get secondarily infected may lead to life threatening complications such as pancreatc abscess which becomes very difficult to treat. Hence proper and timely intervention of giant pancreatic pseudocyst would probably reduce the risk of developing such dangerous complications. In the treatment of pancreatic pseudocyst to prevent recurrence and especially in protection of endocrine function of pancreas internal drainage is found to be more beneficial when compared to other modalities. This case demonstrates the successful use of Roux en Y cystojejunostomy to surgically drain a giant pancreatic pseudocyst at an unusual location.


Giant pseudocyst of pancreas, Roux En Y cystojejunostomy,Chronic pancreatitis.

Full Text:



Misra D, Sood T. Pancreatic Pseudocyst. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2021.

Barthet M, Bugallo M, Moreira LS, Bastid C, Sastre B, Sahel J. Management of cysts and pseudocysts complicating chronic pancreatitis. A retrospective study of 143 patients. Gastroenterol Clin Biol. 1993;17:270-6.

Habashi S, Draganov PV. Pancreatic pseudocyst. World J Gastroenterol. 2009;15:38-47.

Grace PA, Williamson RC. Modern management of pancreatic pseudocysts. Br J Surg. 1993;80:573-81.

Agha RA, Borrelli MR, Farwana R, Koshy K, Fowler A, Orgill DP, SCARE group. The process 2018 statement: updating consensus preferred reporting of CasE series in surgery (PROCESS) guidelines. Int J Surg. 2018;60:279-82.

Sanfey H, Aguilar M, Jones RS. Pseudocysts of the pancreas, a review of 97 cases. Am Surg. 1994;60:661-8.

Cannon JW, Callery MP, Vollmer Jr CM. Diagnosis and management of pancreatic pseudocysts. J Am Coll Surg. 2009;3:385-90.

Pearson Erik G, Scaife Courtney L, Mulvihill Sean J. Roux-en-Y drainage of a pancreatic fistula for disconnected pancreatic duct syndrome after acute necrotizing pancreatitis. HPB 2012;14:26-31.

Nealon WH. In Ch 51, pseudocysts-cysto-gastrostomy, cysto-duodenostomy, and cysto-jejunostomy Atlas. Gen Surg Tech. 2010;578-600.

Tustumi F, Costa TN, Penteado S, Bacchella T, Cecconello I. Long Term Follow-up Results of Surgical Management of Chronic Pancreatitis. Chirurgia (Bucur). 2019;114(3):369-75.