後縦隔内に進展して食道狭窄をきたした膵仮性嚢胞の1例

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  • A CASE OF PANCREATIC PSEUDOCYST WITH POSTERIOR MEDIASTINAL EXTENSION RESULTED IN ESOPHAGEAL STENOSIS

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A 45-year-old man was admitted to Nagasaki University Hospital with a chief complaint of dysphagia. He had a history of many alcohol consumption and recurrent epigastric pain due to previous chronic pancreatitis. On admission, the tenderness was found in epigastrium, and laboratory data showed hyperamylasuria. Upper G-I series revealed distal esophageal compression by a mediastinal mass. Also, in CT scan, water density fluid collection surrounded by enhanced wall which compressed heart and esophagus was found in posteriour mediastinum. At inferior level, the fluid collection connected with the cyst of pancreatic body was noted. Longitudinal ultrasonogram (US) at the midline exhibited the pseudocyst was extending into the posteior mediastinum through the aortic hiatus. The findings obtained from CT scan and US made a diagnosis of the pancreatic pseudocyst with mediastinal extension confirm eventually. By the reason discribed above, US and CT scan are valuable to make a diagnosis of pancreatic pseudocyst and to confirm the extended direction. Extension into the mediastinum by a pancreatic pseudocyst is a relatively rare manifestation and so far only 26 cases were reported in the literature.

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