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Case Reports
. 2018 Jul-Dec;15(3):148-150.
doi: 10.4103/ajps.AJPS_71_17.

Intragastric cystogastrostomy in a 4-year-old child with a pancreatic pseudocyst: A novel technique

Akinori Sekioka  1 , Toshiaki Takahashi  2 , Koji Fukumoto  2 , Naoto Urushihara  2
Affiliations
Case Reports

Intragastric cystogastrostomy in a 4-year-old child with a pancreatic pseudocyst: A novel technique

Akinori Sekioka et al. Afr J Paediatr Surg. 2018 Jul-Dec.

Abstract

Pancreatic pseudocysts (PPs) often occur in association with acute pancreatitis or pancreatic trauma and are uncommon disorders in children. PPs require operative interventions in case they do not disappear spontaneously. There are several interventional treatments, and laparoscopic or endoscopic treatments have been recently reported as a less invasive procedure. However, these procedures are sometimes difficult to perform for small children. We describe a novel intragastric cystogastrostomy with mini-laparotomy for a 4-year-old female child. She presented with a PP caused by trauma. The PP failed to resolve after 6 weeks and we performed open cystogastrostomy. We made mini-laparotomy and inserted a wound retractor into the stomach and expanded both the abdominal and the gastric walls. This procedure created a good operative field and enabled intragastric cystogastrostomy even in small children. There were no complications. At 10-month postsurgery, a follow-up computed tomography showed no recurrence of PP. This novel intragastric cystogastrostomy for PP, which includes the insertion of a wound retractor, is a safe, minimally invasive, and technically feasible approach for younger children with PP. To the best of our knowledge, this is the first report to describe the intragastric cystogastrostomy with a wound retractor.

Keywords: Children; intragastric surgery; open cystogastrostomy; pancreatic pseudocyst; wound retractor.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
This abdominal computed tomography axial section showing a pancreatic pseudocyst measuring 6 cm × 6 cm at the body of the pancreas
Figure 2
Figure 2
This illustration shows the approach, inserting wound retractor into the stomach
Figure 3
Figure 3
Wound retractor expands both the abdominal wall and anterior wall of the stomach, exposing the cystogastrostoma
Figure 4
Figure 4
Upper gastrointestinal series on the postoperative day 6 showing the cavity of the pancreatic pseudocyst. The size of the pseudocyst has got smaller
See this image and copyright information in PMC

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