Recurrence of Pancreatic Pseudocyst following Endoscopic Ultrasonography-Guided Drainage

A 71-year-old female came to our hospital with
upper abdominal pain, fever, and jaundice, and was
diagnosed with severe acute biliary pancreatitis.
Upon admission, the patient underwent emergency
endoscopic retrograde cholangiopancreatography and
endoscopic sphincterotomy procedures, as well as
endoscopic retrograde biliary drainage. Although
pseudocyst formation was observed, no symptoms
were presented and she was discharged. One month
after, she was admitted again due to pain caused by
pseudocyst enlargement and the symptoms persisted
following conservative treatment. Although we performed
endoscopic ultrasonography-guided drainage
for the pancreatic pseudocyst, abdominal pain continued
and abdominal computed tomography revealed
that the pseudocyst was again enlarged. Since insufficient
drainage seemed to be the cause, additionally
balloon dilatation and placement of plastic stents for
the fistulae were performed. There are no guidelines
available for selection of drainage period or number
of stents in pseudocyst cases, and additional studies
regarding management of affected patients are
needed.