External Drainage Laparotomy as an Option for Management of Pancreatic Pseudocyst in Remote Area: A Case Report

Laparotomi Drainase Eksternal sebagai Pilihan untuk Penanganan Pseudokista Pankreas di Daerah Terpencil: Laporan Kasus

Abstract

Introduction: A pancreatic pseudocyst is a localized fluid collection around the pancreas surrounded by fibrous tissue without epithelial cells. Symptomatic pseudocysts, often resulting from increased size and compression of adjacent organs, require intervention.

Case Description: We report a 21-year-old male who presented with a progressively enlarging left hemiabdominal mass following abdominal trauma from a fall. The patient exhibited symptoms of gastric outlet obstruction, including nausea, postprandial vomiting, early satiety, and abdominal discomfort. An initial transabdominal ultrasound suggested a hematoma or abscess. During laparotomy, a pancreatic pseudocyst compressing the stomach was identified, and external drainage was performed, releasing 2000 cc of fluid. The patient fully recovered without complications.

Discussion: Pancreatic pseudocysts can result from pancreatic duct disruption due to blunt abdominal trauma. The choice of drainage method depends on the cyst's location, wall maturation, and content. In this case, external drainage via laparotomy was chosen due to the pseudocyst's immature wall and limited diagnostic and therapeutic options.

Conclusion: This report highlights that external drainage laparotomy is a feasible therapeutic approach for managing immature pancreatic pseudocysts, especially in resource-limited settings.