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Double pigtail gastrocystic stent

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Chronic relapsing pancreatitis with recurrent large pseudocysts in the body of the pancreas and the left pararenal space. Two double pigtail stents linking the cysts with the stomach have been endoscopically introduced before.

Patient Data

Age: 50
Gender: Female

Control erect abdominal radiograph prior to planned removal of the devices shows two double pigtail stents in a normal position linking the expected location of the pancreatic body and the gastric fundus. 

6 weeks earlier CT

ct

Prior CT provided for explanation:

  • A large pseudocyst is visible in the body of the pancreas, compressing a short segment of the inferior vena cava and stomach. A short segment of common hepatic artery is passing through the pseudocyst. A smaller, similar lesion can be seen in the left anterior pararenal space, that cannot be separated from the lienal flexure. Circumscribed bowel wall thickening in this area.
  • Diffuse intraabdominal low density free fluid 
  • Several enhancing lesions in the liver which are known hemangiomas, as well as superficial triangular hyperdense areas suggestive of perfusion disturbance. 

Case Discussion

Double pigtail gastrocystic stents are sometimes used to drain recurrent pseudocysts in order to avoid more invasive procedures. 

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