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Introduction: Intradiploic pseudomeningoceles, also called intradiploic cerebrospinal fluid (CSF) fistulas, are abnormal CSF collections between the two bony tables of the calvaria resulting from postsurgical CSF leakage. To date, only six cases of intradiploic pseudomeningocele have been reported, all occurring in the occipital area. In this paper, we report the seventh case of late-onset occipital intradiploic pseudomeningocele (OIP) occurring in a young female patient who underwent surgery for the removal of a cerebellar pilocytic astrocytoma. In this regard, we also review the literature on the few recognized cases of OIP. Case Presentation: The case of an 18-year-old female patient known to our institute for an operation 12 years earlier to remove a pilocytic astrocytoma is illustrated. At admission, the patient complained only of occasional orthostatic headache. Brain imaging demonstrated a pseudomeningocele extended intradiploically from the occipital squama to the condylar and clivus regions, thinning both occipital bone tables and dilating the CSF-filled diploe. Watertight duroplasty and cranioplasty were effectively performed. Conclusion: Pediatric patients undergoing posterior cranial fossa craniotomy/craniectomy may postoperatively develop OIP. In this setting, treatment of any dural CSF fistula should be considered because of the risk of progressive extension and bone erosion.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

The pancreas is an important digestive organ located in the upper abdomen. There are several types of pancreatic cysts. Those that contain mucin can cause cancer. These cysts connect with the pancreatic duct and their fluid usually has a high amount of digestive pancreatic enzymes. Cysts can occur in both men and women and are more common in people over 50 years of age. Cysts that are small and stable in size and have no worrisome features have a low risk of developing into cancers. We have set out to review the literature on surgical interventions performed on the organ. Most patients do not present any discomfort, diagnosing the cyst incidentally during an imaging test. If there are symptoms, they are very var-ied. The most frequent are upper abdominal pain and vomiting or jaundice, secondary to the compression of other organs by the cyst, mainly the stomach, duodenum and bile ducts. In most cases, the pseudocyst will resolve with supportive mea-sures. Size and duration are only predictors for the spontaneous resolution of the pseudocyst Percutaneous drainage is recommended as a temporary measure for those patients who are not candidates for surgery The three surgeries available for the management of the pseudocyst are internal drainage, external drainage and pancreatic resection The preferred technique is splenic-sparing resection. Section of the pancreas is safe with mechanical vascular sutures. Laparoscopic splenic-sparing distal pancreatectomy is a safe technique for treating both inflammatory and cystic tumors of the pancreas., O pâncreas é um importante órgão digestivo localizado na parte superior do abdómen. Existem vários tipos de quistos pancreáticos. Os que contêm mucina podem causar cancro. Estes quistos ligam-se ao ducto pancreático e o seu fluido tem normalmente uma grande quantidade de enzimas pancreáticas digestivas. Os quistos podem ocorrer tanto em ho-mens como em mulheres e são mais comuns em pessoas com mais de 50 anos de idade. Os quistos que são pequenos e estáveis em tamanho e não têm características preocupantes têm um baixo risco de se desenvolverem em cancros. Propomo-nos a rever a literatura sobre intervenções cirúrgicas realizadas no órgão. A maioria dos pacientes não apresen-ta qualquer desconforto, diagnosticando o cisto incidentalmente durante um teste de imagem. Se houver sintomas, estes são muito variados. Os mais frequentes são a dor superior abdominal e vómitos ou icterícia, secundária à compressão de outros órgãos pelo cisto, principalmente o estômago, o duodeno e os canais biliares. Na maioria dos casos, o pseudocisto resolve-se com medidas de apoio. O tamanho e a duração são apenas preditores da resolução espontânea do pseu-docisto A drenagem percutânea é recomendada como medida temporária para os pacientes que não são candidatos à cirurgia As três cirurgias disponíveis para a gestão do pseudocisto são drenagem interna, drenagem externa e ressecção pancreática A técnica preferida é a ressecção esplénica. A secção do pâncreas é segura com suturas vasculares mecâ-nicas. A pancreatectomia laparoscópica splenic-sparing distal é uma técnica segura para tratar tumores inflamatórios e císticos do pâncreas., El páncreas es un importante órgano digestivo ubicado en la parte superior del abdomen Existen diversos tipos de quistes pancreáticos. Aquellos que contienen mucina pueden provocar cáncer. Estos quistes se conectan con el conducto pancreático y su líquido habitualmente tiene una gran cantidad de enzimas pancreáticas digestivas. Los quistes pueden producirse tanto en hombres como en mujeres y son más frecuentes en personas de más de 50 años. Los quistes que tienen un tamaño pequeño y estable y que no presentan características preocupantes tienen un riesgo bajo de convertirse en cánceres Nos hemos propuesto a revisar bibliográficamente las investigaciones respecto a las intervenciones quirúrgicas realizadas en el órgano. La mayoría de los pacientes no presentan ninguna molestia, diagnosticándose el quiste de forma incidental durante la realización de alguna prueba de imagen. Si hay síntomas, son muy variados. Los más frecuentes son el dolor abdominal alto y los vómitos o ictericia, secundarios a la compresión de otros órganos por el quiste, fundamentalmente estómago, duodeno y vías biliares. En la mayoría de los casos el pseudoquiste resolverá con medidas de soporte. El tamaño y la duración son apenas predictores para la resolución espontánea del pseudoquiste El drenaje percutáneo se recomienda como una medida temporal para aquello pacientes que no sean candidatos a cirugía Las tres cirugías disponibles para el manejo del pseudoquiste son el drenaje interno, el drenaje externo y la resección pancreática La técnica preferida es la resección con preservación esplénica. La sección del páncreas es segura con las suturas mecánicas vasculares. La pancreatectomía distal con preservación esplénica por laparoscopia es una técnica segura tanto para el tratamiento de los tumores inflamatorios como de los tumores quísticos del páncreas.

Introduction Pseudocyst of pinna is a cystic swelling with collection of serous fluid between the auricular cartilage and perichondrium. Successful treatment of pseudocyst of pinna is challenging because of its high propensity for recurrence and cosmetic deformity. None of the treatment modalities described in literature gives fully satisfactory result. So a novel treatment modality is required which gives good cosmetic outcome with zero recurrence. Materials and Methods                                                        A prospective study was done in the Department of ENT and Head and Neck Surgery of a Government Medical College, West Bengal from April 2014 to March 2017. The effusion was aspirated aseptically with sterilized 10 ml syringe with 18G IV needle. An equal amount of Inj. Dexamethasone and Inj. Gentamicin 80 mg in 1:1 ratio mixed in a new 10 ml syringe was injected into the swelling through the same prick point. Result Most of the patients in this study were males between 31-40 years of age and labourer by profession. Maximum number of patients had swelling involving concha. Only one case of one month old infant had bilateral involvement. All patients were cured without any recurrence or disfigurement. Conclusion The results of present study points to the fact that aspiration and instillation of equal amount of Inj. Dexamethasone and Inj. Gentamicin works very good in treatment of pseudocyst of pinna. This therapy is minimally invasive, less painful, cost-effective and less cumbersome for the surgeon. It gives faster recovery, good cosmetic outcome and recurrence is prevented.

Introduction Pseudocyst of pinna is a cystic swelling with collection of serous fluid between the auricular cartilage and perichondrium. Successful treatment of pseudocyst of pinna is challenging because of its high propensity for recurrence and cosmetic deformity. None of the treatment modalities described in literature gives fully satisfactory result. So a novel treatment modality is required which gives good cosmetic outcome with zero recurrence. Materials and Methods                                                        A prospective study was done in the Department of ENT and Head and Neck Surgery of a Government Medical College, West Bengal from April 2014 to March 2017. The effusion was aspirated aseptically with sterilized 10 ml syringe with 18G IV needle. An equal amount of Inj. Dexamethasone and Inj. Gentamicin 80 mg in 1:1 ratio mixed in a new 10 ml syringe was injected into the swelling through the same prick point. Result Most of the patients in this study were males between 31-40 years of age and labourer by profession. Maximum number of patients had swelling involving concha. Only one case of one month old infant had bilateral involvement. All patients were cured without any recurrence or disfigurement. Conclusion The results of present study points to the fact that aspiration and instillation of equal amount of Inj. Dexamethasone and Inj. Gentamicin works very good in treatment of pseudocyst of pinna. This therapy is minimally invasive, less painful, cost-effective and less cumbersome for the surgeon. It gives faster recovery, good cosmetic outcome and recurrence is prevented.

Introduction Pseudocyst of pinna is a cystic swelling with collection of serous fluid between the auricular cartilage and perichondrium. Successful treatment of pseudocyst of pinna is challenging because of its high propensity for recurrence and cosmetic deformity. None of the treatment modalities described in literature gives fully satisfactory result. So a novel treatment modality is required which gives good cosmetic outcome with zero recurrence. Materials and Methods                                                        A prospective study was done in the Department of ENT and Head and Neck Surgery of a Government Medical College, West Bengal from April 2014 to March 2017. The effusion was aspirated aseptically with sterilized 10 ml syringe with 18G IV needle. An equal amount of Inj. Dexamethasone and Inj. Gentamicin 80 mg in 1:1 ratio mixed in a new 10 ml syringe was injected into the swelling through the same prick point. Result Most of the patients in this study were males between 31-40 years of age and labourer by profession. Maximum number of patients had swelling involving concha. Only one case of one month old infant had bilateral involvement. All patients were cured without any recurrence or disfigurement. Conclusion The results of present study points to the fact that aspiration and instillation of equal amount of Inj. Dexamethasone and Inj. Gentamicin works very good in treatment of pseudocyst of pinna. This therapy is minimally invasive, less painful, cost-effective and less cumbersome for the surgeon. It gives faster recovery, good cosmetic outcome and recurrence is prevented.

BACKGROUND: In collaboration with United European Gastroenterology, the working group on 'Harmonizing diagnosis and treatment of chronic pancreatitis across Europe' (HaPanEU) developed European guidelines for the management of chronic pancreatitis using an evidence-based approach. METHODS: Recommendations of multidisciplinary review groups based on systematic literature reviews to answer predefined clinical questions are summarised. Recommendations are graded using the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS: Recommendations covered topics related to the clinical management of chronic pancreatitis: aetiology, diagnosis of chronic pancreatitis with imaging, diagnosis of pancreatic exocrine insufficiency, surgical therapy, medical therapy, endoscopic therapy, treatment of pancreatic pseudocysts, pancreatic pain, nutrition and malnutrition, diabetes mellitus and the natural course of the disease and quality of life. CONCLUSIONS: The HaPanEU/United European Gastroenterology guidelines provide evidence-based recommendations concerning key aspects of the medical and surgical management of chronic pancreatitis based on current available evidence. These recommendations should serve as a reference standard for existing management of the disease and as a guide for future clinical research. This article summarises the HaPanEU recommendations and statements.

Background: Pancreatic duct disruption is a challenging condition leading to pancreatic juice leakage and consequently to pancreatic fluid collections. The manifestations of pancreatic main duct leak include pseudocysts, walled-off necrosis, pancreatic fistulas, ascites, pleural and pericardial effusions. Pseudocyst formation is the most frequent outcome of a pancreatic duct leak. Case presentation: We describe a case of a 64-year old man with large multiple pancreatic cysts discovered for progressive jaundice and significant weight loss in the absence of a previous episode of acute pancreatitis. Computed tomography scan showed lesion with thick enhancing walls. The main cyst dislocated the stomach and the duodenum inducing intra and extrahepatic bile ducts enlargement. Magnetic resonance cholangiopancreatography revealed a communication between the main pancreatic duct and the cystic lesions due to Wirsung duct rupture. Endoscopic ultrasound guided fine needle aspiration cytology did not show neoplastic cells and cyst fluid analysis revealed high amylase concentration. Preoperative exams were suggestive but not conclusive for a benign lesion. Laparotomy was necessary to confirm the presence of large communicating pseudocysts whose drainage was performed by cystogastrostomy. Histology confirmed the inflammatory nature of the cyst wall. Subsequently, the patient had progressive jaundice resolution. Conclusion: Pancreatic cystic masses include several pathological entities, ranging from benign to malignant lesions. Rarely pseudocysts present as complex cystic pancreatic lesions with biliary compression in absence of history of acute pancreatitis. We describe the rare case of multiple pancreatic pseudocysts due to Wirsung duct rupture in absence of previous trauma or acute pancreatitis. Magnetic resonance showed the presence of communication with the main pancreatic duct and endoscopic ultrasound fine needle aspiration suggested the benign nature of the lesion

Background: Pancreatic duct disruption is a challenging condition leading to pancreatic juice leakage and consequently to pancreatic fluid collections. The manifestations of pancreatic main duct leak include pseudocysts, walled-off necrosis, pancreatic fistulas, ascites, pleural and pericardial effusions. Pseudocyst formation is the most frequent outcome of a pancreatic duct leak. Case presentation: We describe a case of a 64-year old man with large multiple pancreatic cysts discovered for progressive jaundice and significant weight loss in the absence of a previous episode of acute pancreatitis. Computed tomography scan showed lesion with thick enhancing walls. The main cyst dislocated the stomach and the duodenum inducing intra and extrahepatic bile ducts enlargement. Magnetic resonance cholangiopancreatography revealed a communication between the main pancreatic duct and the cystic lesions due to Wirsung duct rupture. Endoscopic ultrasound guided fine needle aspiration cytology did not show neoplastic cells and cyst fluid analysis revealed high amylase concentration. Preoperative exams were suggestive but not conclusive for a benign lesion. Laparotomy was necessary to confirm the presence of large communicating pseudocysts whose drainage was performed by cystogastrostomy. Histology confirmed the inflammatory nature of the cyst wall. Subsequently, the patient had progressive jaundice resolution. Conclusion: Pancreatic cystic masses include several pathological entities, ranging from benign to malignant lesions. Rarely pseudocysts present as complex cystic pancreatic lesions with biliary compression in absence of history of acute pancreatitis. We describe the rare case of multiple pancreatic pseudocysts due to Wirsung duct rupture in absence of previous trauma or acute pancreatitis. Magnetic resonance showed the presence of communication with the main pancreatic duct and endoscopic ultrasound fine needle aspiration suggested the benign nature of the lesion

Background and aims: In the majority of benign and malignant causes of biliary obstruction, drainage can be achieved via endoscopic retrograde cholangiography (ERC). However, in cases of failed ERC, the management algorithm usually encompasses percutaneous transhepatic cholangiography (PTC) or surgical bypass. The latter two are associated with significant morbidity. Therefore, a minimally invasive approach is preferable. The evolution of therapeutic EUS has permitted development of novel drainage techniques without the need for external drainage catheters or major surgery. The aim of this study is to evaluate outcomes of EUS-drainage procedures in benign and malignant causes of biliary obstruction. Method(s): This is a multicentre, retrospective review of all patients undergoing EUS-guided intervention to achieve drainage of the biliary tree. Patient demographics, procedural technical data, pre- and post- procedure bilirubin and adverse events were recorded. Technical success was defined as placement of stent in intended location. Clinical success was defined as >50% decline in bilirubin 2 weeks post procedure. Result(s): Between October 2013 and May 2016, a total of 14 patients, (mean age 63 +/- 19 years, 8/14 male) underwent EUS-biliary drainage procedures at 3 tertiary academic centres. Majority (72%) were for malignant obstruction (pancreatic cancer, n = 6, cholangiocarcinoma, n = 2, colorectal cancer metastasis, n = 2) and 28% (4/14) were for benign disease (benign biliary stricture, n = 2, cholangitis, n = 1, cholecystitis, n = 1). Reasons for failed ERC included obscured ampulla (n = 4), gastric outlet obstruction (n = 3), failed deep wire cannulation (n = 5), 1 ampulla within diverticulum and 1 patient unfit for laparoscopic cholecystectomy. EUS-guided drainage was performed via extrahepatic access in 64% (9/14) of cases. Seven choledochoduodenostomies, 4 hepatogastrostomies, 1 rendezvous, 1 antegrade stent and 1 gallbladder drainage were performed. Tract d

Background and aims: In the majority of benign and malignant causes of biliary obstruction, drainage can be achieved via endoscopic retrograde cholangiography (ERC). However, in cases of failed ERC, the management algorithm usually encompasses percutaneous transhepatic cholangiography (PTC) or surgical bypass. The latter two are associated with significant morbidity. Therefore, a minimally invasive approach is preferable. The evolution of therapeutic EUS has permitted development of novel drainage techniques without the need for external drainage catheters or major surgery. The aim of this study is to evaluate outcomes of EUS-drainage procedures in benign and malignant causes of biliary obstruction. Method(s): This is a multicentre, retrospective review of all patients undergoing EUS-guided intervention to achieve drainage of the biliary tree. Patient demographics, procedural technical data, pre- and post- procedure bilirubin and adverse events were recorded. Technical success was defined as placement of stent in intended location. Clinical success was defined as >50% decline in bilirubin 2 weeks post procedure. Result(s): Between October 2013 and May 2016, a total of 14 patients, (mean age 63 +/- 19 years, 8/14 male) underwent EUS-biliary drainage procedures at 3 tertiary academic centres. Majority (72%) were for malignant obstruction (pancreatic cancer, n = 6, cholangiocarcinoma, n = 2, colorectal cancer metastasis, n = 2) and 28% (4/14) were for benign disease (benign biliary stricture, n = 2, cholangitis, n = 1, cholecystitis, n = 1). Reasons for failed ERC included obscured ampulla (n = 4), gastric outlet obstruction (n = 3), failed deep wire cannulation (n = 5), 1 ampulla within diverticulum and 1 patient unfit for laparoscopic cholecystectomy. EUS-guided drainage was performed via extrahepatic access in 64% (9/14) of cases. Seven choledochoduodenostomies, 4 hepatogastrostomies, 1 rendezvous, 1 antegrade stent and 1 gallbladder drainage were performed. Tract d

Small bowel perforation is a rare complication of ventriculoperitoneal (VP) shunt placement. When seen, it most commonly affects the stomach or colon. We describe a case and image findings of an 8-year-old female who presented with sepsis and erosion of the VP shunt into the small bowel. The imaging findings were confirmed surgically. We also provide an overview of the current literature discussing previously reported cases, clinical features, and treatment.

Adrenal cystic lesions are rare entities. Four types of cystic lesions of the adrenal gland have been described in literature namely, epithelial cysts, endothelial cysts, pseudocysts and parasitic cysts. Tumors of the adrenal gland, both benign and malignant may also show cystic change and have to be considered in the differential diagnosis of cystic lesions of the adrenal gland. Lymphangioendotheliomas, though common at other sites, are unusual in the adrenal glands and bilateral involvement is extremely rare. We present four cases of adrenal cysts, two cases of lymphangioendothelial cysts and two cases of pseudocysts from 108 adrenalectomy specimens received over 5 years. Two of these had hypertension which resolved after surgery. All of our cases did well postoperatively. Prognosis of these benign cysts is excellent and the patients are disease-free after surgery.

Stent migration into pancreatic pseudocysts during endosonographic (EUS) cystogastrostomy is a relatively rare complication. The migrated stent may induce, if it remains within the body, infection and perforation. Therefore, retrieval and/or re-stenting is necessary. Endoscopic retrieval is commonly attempted first. However, it is technically challenging and largely dependent on the skill of the endoscopists; if retrieval is unsuccessful, surgery is usually carried out. We report a case of stent migration into a pancreatic pseudocyst that was retrieved with a percutaneous approach under imaging guidance using a simple technique with available devices. A technique that enhances the role of interventional radiology in the management of this rare complication.

UVOD: U poslednjih nekoliko godina zapaža se porast učestalosti akutnog pankreatitisa (AP) kod odraslih kao i kod dece. Prevalenca AP kod odraslih iznosi od 6–45/100.000 godišnje dok se u dečijoj populaciji kreće od 3,6 do 13,2 slučaja na 100.000 dece. Težina kliničke slike AP varira od blage forme do fulminantne životno ugrožavajuće, praćene brojnim komplikacijama. Zato je nastala potreba za odreĎivanjem novog prognostičkog markera koji može pomoći pedijatrima u predviĎanju toka i ishoda AP. Poremećaji koagulacije koji nastaju u AP mogu biti različitog intenziteta od potrošne koaglopatije pa sve do fatalne diseminovane intravaskularne koagulacije (DIC). U ranije objavljenim studijama ispitivani su različiti parametri hemostaze kao potencijalni prognostički markeri toka i ishoda bolesti. OdreĎivanje nivoa D-dimera, koji se od ranije koriste u kliničkoj praksi kao efikasno dijagnostičko sredstvo za dokazivanje dubokih venskih tromboza i plućne embolije, ima i značajnu ulogu u predviĎanju toka bolesti u ranoj fazi akutnog pankreatitisa. CILJ: Cilj ovog rada je utvrditi ulogu D- dimera u predviĎanju nastanka dve najvažnije lokalne i sistemske komplikacije akutnog pankreatitisa u dece (pseudocista pankreasa i sindrom multiplog popuštanja organa-MOF). TakoĎe smo analizirali korelaciju nivoa D-dimera i kliničkih znakova akutnog pankreatitisa (tahikardija, hipertenzija, ikterus) i ispitivali povezanost izmeĎu nivoa D-dimera i ostalih laboratorijskih pokazatelja aktivnosti akutnog pankreatitisa..., BACKGROUND: Recently published articles describe an increasing incidence of acute pancreatitis (AP) in both children and adults. The prevalence of acute pancreatitis is estimated between 6–45 per 100.000 adults per year and between 3,6 and 13,2 cases per 100.000 children. The severity of acute pancreatitis can range from mild disease to a severe life-treatening disease associated with multiple complications.Therefore, there is a need for an ideal prognostic marker of disease severity that can help the pediatricians to predict clinical course and possible outcome of AP. Coagulation abnormalities always occur in AP, ranging from localized intravascular thrombosis to severe disseminated intravascular coagulation (DIC) and are related to disease severity. Several biochemical markers and haemostatic parameters have been used to assess severity and outcome of AP. Some previous studies reported that D-dimer level, commonly used parameter in the diagnosis of deep vein thrombosis as well as pulmonary embolism, have predictive power in the early phase of AP in adults . THE AIM: The aim of this study was to assess the value of the plasma D-dimer level in the prediction of two most inmportant local and sistemic complications of acute pancreatitis in children (pseudocyst fomation and multiple organ failure –MOF). We had also analyzed the correlation between D- dimer level and the presence of clinical signs of acute pancreatitis (tachycardia, hypotension, jaundice) and we examined the connection between D- dimer level and the other laboratory severity markers...

Introduction: Since its introduction to medical practice 30 years ago, endoscopic ultrasound (EUS) has undergone numerous technological advancements and is now a widely used diagnostic and therapeutic procedure. This survey was conducted to assess the current practice and utilisation of EUS in Australia. Method(s): 77 specialists who are registered as echoendoscopists on the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy (CCRTGE) database were invited via email to complete a survey comprising of 47 questions. Result(s): We achieved an interim survey response rate of 26% (20 respondents) from a total of 77 invited endoscopists within a fortnight of distribution. All respondents were gastroenterologists, and the majority practiced in the states ofVictoria (40%) and NewSouthWales (40%). Echoendoscopists tended to be male (85%) with age range between 34 to 63 years (mean age 43 years), and experience ranged from 2 to 25 years with 75% having equal or less than 10 years experience. All respondents were still in active practice with relation to EUS, and 65% also regularly perform ERCP. 75% of the cohort underwent fellowship training for EUS; of which only 15% completed training in Australia alone, and the vast majority (65%) undergoing a combination of overseas and local training. EUS was largely performed in tertiary referral hospitals (70%), with private hospitals (20%) and secondary care hospitals (10%) making up the remainder. EUS procedures were always performed under sedation (100%) across Australia, and predominantly for diagnostic evaluation (86%). Performance volumes ranged from 25 to 600 cases per annum (mean 199 cases). The mean institutional case volume was 337 cases per annum; one high volume centre performing 1200 cases annually. Australian centres possessed on average 1.4 radial echoendoscopes and 2 linear echoendoscopes (range 1 to 3), though linear scopes were the preferred "workhorse", being utilised 76% of the time. Sur

Introduction: Since its introduction to medical practice 30 years ago, endoscopic ultrasound (EUS) has undergone numerous technological advancements and is now a widely used diagnostic and therapeutic procedure. This survey was conducted to assess the current practice and utilisation of EUS in Australia. Method(s): 77 specialists who are registered as echoendoscopists on the Conjoint Committee for the Recognition of Training in Gastrointestinal Endoscopy (CCRTGE) database were invited via email to complete a survey comprising of 47 questions. Result(s): We achieved an interim survey response rate of 26% (20 respondents) from a total of 77 invited endoscopists within a fortnight of distribution. All respondents were gastroenterologists, and the majority practiced in the states ofVictoria (40%) and NewSouthWales (40%). Echoendoscopists tended to be male (85%) with age range between 34 to 63 years (mean age 43 years), and experience ranged from 2 to 25 years with 75% having equal or less than 10 years experience. All respondents were still in active practice with relation to EUS, and 65% also regularly perform ERCP. 75% of the cohort underwent fellowship training for EUS; of which only 15% completed training in Australia alone, and the vast majority (65%) undergoing a combination of overseas and local training. EUS was largely performed in tertiary referral hospitals (70%), with private hospitals (20%) and secondary care hospitals (10%) making up the remainder. EUS procedures were always performed under sedation (100%) across Australia, and predominantly for diagnostic evaluation (86%). Performance volumes ranged from 25 to 600 cases per annum (mean 199 cases). The mean institutional case volume was 337 cases per annum; one high volume centre performing 1200 cases annually. Australian centres possessed on average 1.4 radial echoendoscopes and 2 linear echoendoscopes (range 1 to 3), though linear scopes were the preferred "workhorse", being utilised 76% of the time. Sur

BackgroundTraumatic pulmonary pseudocysts (TPPs) are rare sequelae of blunt chest trauma and may be incidentally visualized on initial, or subsequent, chest imaging.CaseWe present the case of a 37-year-old male with no past medical history, who was recently hospitalized in the intensive care unit after a motor vehicle accident and referred to our institution for a traumatic cataract repair. His preoperative chest radiograph revealed multiple left-sided pulmonary nodules that were confirmed on thoracic computed tomography (CT) and noted to be cavitary. Comparison of the films to prior imaging, negative infectious workup, and absence of any symptoms led to the diagnosis of TPPs. Follow-up imaging showed complete resolution of the lesions.ConclusionThe TPPs may be discovered on imaging shortly after blunt chest trauma and, in asymptomatic individuals, can often be monitored with observation and serial imaging.

The relevance of pancreatic cyst treatment is determined by the increase in the incidence of pancreatitis, a considerable number of complications and high mortality rate. In recent decades, there has been steady growth of destructive forms of pancreatitis, respectively the number of pancreatic cysts increases. Pancreatic cysts in 18–68 % of cases cause various complications (suppuration, perforation, bleeding, internal and external fistulas, malignant transformation) that define high mortality — 9.2–53 %. The nature and extent of surgery depend on the etiology, the presence or absence of the cyst connection with ductal system, the presence of complications. Surgical treatment for pancreatic cysts remains the method of choice. Minimally invasive surgical procedures became widely used. High prevalence of cystic lesions of the pancreas, the difficulty of choosing the optimal method of treatment require the creation of a rational, convenient for clinical practice diagnostic and therapeutic algorithm. Dissatisfaction with the results of treatment and a large number of complications lead to the search for a new, so called gold standard for treatment of patients and determine the real place of minimally invasive and open surgical techniques., Актуальность лечения кист поджелудочной железы (ПЖ) определяется увеличением заболеваемости панкреатитом, значительным количеством осложнений и высокой летальностью. В последние десятилетия отмечается неуклонный рост деструктивных форм панкреатита, соответственно увеличивается количество кист ПЖ. Кисты поджелудочной железы в 18–68 % вызывают различные осложнения (нагноение, перфорация, кровотечение, внутренние и наружные свищи, малигнизация), что определяет высокую летальность — 9,2–53 %. Характер и объем оперативного вмешательства зависят от этиологии, наличия или отсутствия связи кисты с протоковой системой, наличия осложнений. Хирургический способ лечения при кистах поджелудочной железы остается методом выбора. Широкое применение получили малоинвазивные хирургические вмешательства. Большая распространенность кистозных поражений ПЖ, трудности выбора оптимального способа лечения требуют создания рационального, удобного для клинической практики диагностически-лечебного алгоритма. Неудовлетворенность результатами лечения и большое количество осложнений побуждают к поискам нового, так называемого золотого стандарта лечения больных и определению реального места мини-инвазивных и открытых хирургических методов., Актуальність лікування кіст підшлункової залози (ПЗ) визначається збільшенням захворюваності панкреатитом, значною кількістю ускладнень та високою летальністю. В останні десятиріччя відмічається неухильне зростання деструктивних форм панкреатиту, відповідно збільшується кількість кіст ПЗ. Кісти підшлункової залози в 18–68 % викликають різні ускладнення (нагноєння, перфорація, кровотеча, внутрішні та зовнішні нориці, малігнізація), що визначає високу летальність — 9,2–53 %. Характер та об’єм оперативного втручання залежать від етіології, наявності або відсутності зв’язку кісти з протоковою системою, наявності ускладнень. Хірургічний спосіб лікування при кістах підшлункової залози залишається методом вибору. Широке застосування отримали малоінвазивні хірургічні втручання. Велика поширеність кістозних уражень ПЗ, труднощі вибору оптимального способу лікування вимагають створення раціонального, зручного для клінічної практики діагностично-лікувального алгоритму. Незадоволеність результатами лікування та велика кількість ускладнень спонукають до пошуків нового, так званого золотого стандарту лікування хворих та визначення реального місця міні-інвазивних та відкритих хірургічних методів.

BackgroundTraumatic pulmonary pseudocysts (TPPs) are rare sequelae of blunt chest trauma and may be incidentally visualized on initial, or subsequent, chest imaging.CaseWe present the case of a 37-year-old male with no past medical history, who was recently hospitalized in the intensive care unit after a motor vehicle accident and referred to our institution for a traumatic cataract repair. His preoperative chest radiograph revealed multiple left-sided pulmonary nodules that were confirmed on thoracic computed tomography (CT) and noted to be cavitary. Comparison of the films to prior imaging, negative infectious workup, and absence of any symptoms led to the diagnosis of TPPs. Follow-up imaging showed complete resolution of the lesions.ConclusionThe TPPs may be discovered on imaging shortly after blunt chest trauma and, in asymptomatic individuals, can often be monitored with observation and serial imaging.

Pseudocysts containing activated enzymes are a common complication of pancreatitis. Pseudocysts can rupture into adjacent structures including the peritoneal cavity, adjacent organs, and rarely vascular structures. While arterial pseudoaneurysms and venous thrombosis or occlusion are well known complications of acute and chronic pancreatitis, only 17 cases of pancreas-portal venous fistula have been encountered in review of the literature. A patient with chronic pancreatitis presented with a history of weight loss, fatigue and was found to have a pancreatic duct-portal vein fistula. The patient was treated surgically with good outcome.

Autoimmune pancreatitis (AIP) is a new category of pancreatic diseases. AIP associated with pseudocysts is rare; only 8 cases have been reported in the literature. A 63-year-old man was admitted to our department because of upper left abdominal pain and back pain. Various imaging studies demonstrated swelling of the tail of the pancreas with hemorrhagic pseudocysts. The patient underwent a surgical operation. A pancreatogram of the specimen revealed total occlusion of the main pancreatic duct in the tail of the pancreas. Histopathological examination revealed that it was AIP with hemorrhagic pseudocysts.

Autoimmune pancreatitis (AIP) is a new category of pancreatic diseases. AIP associated with pseudocysts is rare; only 8 cases have been reported in the literature. A 63-year-old man was admitted to our department because of upper left abdominal pain and back pain. Various imaging studies demonstrated swelling of the tail of the pancreas with hemorrhagic pseudocysts. The patient underwent a surgical operation. A pancreatogram of the specimen revealed total occlusion of the main pancreatic duct in the tail of the pancreas. Histopathological examination revealed that it was AIP with hemorrhagic pseudocysts.

Autoimmune pancreatitis (AIP) is a new category of pancreatic diseases. AIP associated with pseudocysts is rare; only 8 cases have been reported in the literature. A 63-year-old man was admitted to our department because of upper left abdominal pain and back pain. Various imaging studies demonstrated swelling of the tail of the pancreas with hemorrhagic pseudocysts. The patient underwent a surgical operation. A pancreatogram of the specimen revealed total occlusion of the main pancreatic duct in the tail of the pancreas. Histopathological examination revealed that it was AIP with hemorrhagic pseudocysts.

Post-operative pancreatic fistulae represent a challenge for all the actors in gastroenterology: for surgeons, because they want to prevent and treat conservatively this complication since re-operation is associated with high morbidity and mortality rates; for radiologists, because they have to provide the best staging and informations without any additional risk; and for endoscopists, because endoluminal treatment is emerging as a safe and effective procedure provided it is performed in highly experienced tertiary centres in the setting of a multidisciplinary approach. Herein, we review the definitions, the causes, the staging and the possible options to prevent or treat post-operative pancreatic fistulae. Special attention is paid to the endoscopic management of this complication: including the relief of ductal obstructions, the stenting of leakages and the drainage of bulging or non-bulging fluid collections. Practical problems and issues are clearly outlined as well as the need for future improvements in staging and management of the patients having such complications., Journal Article, Review, info:eu-repo/semantics/published

Post-operative pancreatic fistulae represent a challenge for all the actors in gastroenterology: for surgeons, because they want to prevent and treat conservatively this complication since re-operation is associated with high morbidity and mortality rates; for radiologists, because they have to provide the best staging and informations without any additional risk; and for endoscopists, because endoluminal treatment is emerging as a safe and effective procedure provided it is performed in highly experienced tertiary centres in the setting of a multidisciplinary approach. Herein, we review the definitions, the causes, the staging and the possible options to prevent or treat post-operative pancreatic fistulae. Special attention is paid to the endoscopic management of this complication: including the relief of ductal obstructions, the stenting of leakages and the drainage of bulging or non-bulging fluid collections. Practical problems and issues are clearly outlined as well as the need for future improvements in staging and management of the patients having such complications., Journal Article, Review, info:eu-repo/semantics/published

SCOPUS: ar.j, info:eu-repo/semantics/published

SCOPUS: ar.j, info:eu-repo/semantics/published