Endoscopic Ultrasound-guided Trans-esophageal Transmural Drainage of Mediastinal Pseudocysts: A Case Series

Authors

  • Surinder Singh Rana Gastroenterology Departement, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • Arup Choudhary Gastroenterology Departement, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • Daya Krishna Jha Gastroenterology Departement, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • Pankaj Kumar Gastroenterology Departement, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • Rajesh Gupta Surgical Gastroenterology Departement, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

DOI:

https://doi.org/10.15403/jgld-4530

Keywords:

pseudocyst, mediastinum, acute pancreatitis, chronic pancreatitis, endoscopic ultrasound, endoscopic retrograde pancreatography

Abstract

Background and Aims: Mediastinal pseudocysts (MP) are rare, and surgery is the conventional treatment modality. However, in the last decade, excellent outcomes have been reported with endoscopic transpapillary drainage. Endoscopic ultrasound (EUS) guided trans-esophageal transmural drainage of MP is a minimally invasive and effective non-surgical treatment modality, but the experience is limited. We aimed to report our experience of EUS-guided transmural drainage in 10 patients with MP‘s.

Methods: A retrospective analysis of patients with pancreatic fluid collections treated with EUS-guided transmural drainage over the last ten years was completed to to identify patients with MP‘s.

Results: Ten patients (8 males, with a mean age of 34.9±9.17 years) with MP treated with EUS-guided transesophageal transmural drainage were identified. Nine patients with MP had concurrent chronic pancreatitis, and only one had MP following acute necrotizing pancreatitis. The mean size of MP was 5.70±1.64 cm, and nine patients (90%) had concurrent abdominal pseudocyst. EUS-guided transesophageal transmural drainage was technically successful in all ten patients. Transmural plastic stents were placed in 9 patients, whereas one patient underwent single-time complete aspiration of the MP. There were no immediate or delayed procedure-related complications. All ten patients had a successful outcome, with the mean resolution time being 2.80±0.79 weeks. There has been no recurrence of PFC or symptoms in nine (90%) successfully treated patients over a mean follow-up period of 43.3 months.

Conclusions: EUS-guided trans-esophageal drainage of MP is safe with a high technical and clinical success rate.

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Published

2023-03-31

How to Cite

1.
Rana SS, Choudhary A, Jha DK, Kumar P, Gupta R. Endoscopic Ultrasound-guided Trans-esophageal Transmural Drainage of Mediastinal Pseudocysts: A Case Series. JGLD [Internet]. 2023 Mar. 31 [cited 2025 Jul. 14];32(1):58-64. Available from: https://jgld.ro/jgld/index.php/jgld/article/view/4530

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Original Article