Mediastinal Pancreatic Pseudocyst: A Rare Cause of New Onset Dysphagia

摘要

A pancreatic pseudocyst is a collection of pancreatic secretions encased in a fibrous tissue layer, without a true lining of epithelium. They form because of either stenosis or disruption of the pancreatic duct and are seen after both acute and chronic pancreatitis (incidence 6-18.5 vs 20-40%, respectively). Although most are found near the pancreas, they can invade adjacent organs or even extend above the diaphragm. Mediastinal pseudocysts are a rare complication of pancreatitis. We present a patient with a history of gallstone pancreatitis who presented to the hospital with complaints of worsening abdominal pain, chest pain and pressure, and new onset dysphagia who was found to have a pancreatic pseudocyst with mediastinal extension. A 36-year-old white woman with a history of multiple sclerosis and alcoholic cirrhosis presented to the emergency room with complaints of gradually worsening abdominal pain with associated chest pain and pressure, and a two-day history of dysphagia to solid foods. She had been admitted the month prior for gallstone pancreatitis, but had not yet had a chole-cystectomy given her underlying cirrhosis and concern for hepatic decompensation after surgery.