GASTROENTEROLOGY ARTICLE OF THE WEEK
January 26, 2006
Baillie J. Pancreatic pseudocysts (Part II). Gastrointest Endosc 2004;60:105-113.
1. Planning for cyst drainage
a. An ERCP should be performed, if communication with the PD, place a stent across
the ruptured area or into the cyst cavity itself
b. If the cyst wall is >10mm in width, surgical approach is preferred
c. If the cyst contains necrotic material, endoscopic drainage is contraindicated
d. if the communication with the PD cannot be stented, resolution is less likely with percutaneous or endoscopic drainage
True or False
2. Endoscopic drainage is generally avoided in the management of acute fluid collections of the pancreas.
3. An EUS exam should be done prior to endoscopic cyst drainage to identify the presence of vascular structures.
4. The safety and efficacy of endoscopic pseudocyst drainage is well established in the literature.
5. The finding of solid material in the fluid collection markedly increases the risk of infection after endoscopic cyst drainage and requires antibiotic coverage.
6. After angiographic embolization of a splenic artery pseudoanerysm, it is safe to proceed with endoscopic or percutaneous cyst drainage.
7. If a stent migrates totally into the pseudocyst, surgery is necessary.