A Rare Case Report of Pseudocyst of Pancreas in Pregnancy

Pseudocyst in pregnancy is a rare condition whose management is not standardized. Hyperlipidemia is overrepresented as a cause of pancreatic pseudocysts in pregnancy, causing more cases than alcoholic and biliary pancreatitis combined. : A 20 year old primi with 20weeks of gestation was referred from Obstetrics department in view of epigastric pain which is radiating to back since 15 days and early satiety. Initial size of the cyst was 7*5 cm. On conservative management, patient developed worsening of pain and increase in size of epigastric mass. . On MRI abdomen a 20*15cm pseudocyst of pancreas is noted in the body of pancreas with wall thickness of 8mm which is abutting the posterior wall of stomach. We performed open cystogastrostomy at 24 weeks of gestation under general anesthesia with a 4cm epigastric incision. There is complete resolution of symptoms and cyst on followup. It should be differentiated from papillary cystic neoplasm. MRI abdomen is the IOC. The natural history is same as that of pseudocysts seen in non gravid patients. Asymptomatic pseudocysts should be managed coservatively. Symptomatic, enlarging, very large and complicated pseudocysts needs intervention. Open Cystogastrostomy can be safely done without any complications to mother and foetus in centres which donot have technical expertise to perform endoscopic cystogastrostomy. . Preterm labour is the obstetric complication that may occur as a result of pseudocyst along with other complications that are associated with pseudocyst.