Mediastinal Pancreatic Pseudocyst Associated with Esophageal Hiatus Hernia: Report of a Case

Taihei Koh, Masahiko Miyata, Noritsugu Ogawa, Masaaki Izukura, Masahiro Nakamura, Toru Kitagawa, Tokio Yamaguchi, Kazuyasu Nakao, Yasunaru Kawashima

The First Department of Surgery, Osaka University Medical School

We report a case of mediastinal pancreatic pseudocyst associated with esophageal hiatus hernia. The patient, a 54-year-old man who had a history of chronic pancreatitis, complained of epigastralgia and back pain. A gastrointestinal series showed displacement of the lower esophagus. Computed tomography revealed a 5 cm cyst behind the lower esophagus. Five months later, the mediastinal cyst had decreased in size to 2 cm in diameter and a new 7 cm cystic mass appeared at the tail of the pancreas. Distal pancreatectomy and extirpation of the mediastinal cyst through the esophageal hiatus hernia were performed. Thirty-five cases reported mediastinal pancreatic psuedocysts world-wide were reviewed. When there was communication between the mediastinal and abdominal cysts, the abdominal cyst was drained. But when there was no communication, external drainage or extirpation of the mediastinal cyst was performed.

Key words
mediastinal pancreatic pseudocyst, esophageal hiatus hernia

Reprint requests
Masahiko Miyata The First Department of Surgery, Osaka University Medical School
1-1-50 Fukushima, Fukushima-ku, Osaka, 553 JAPAN

Accepted
December 13, 1989

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