A 60-year-old male patient with a history of several episodes of acute pancreatitis of alcoholic origin.
The patient presented with fever, malaise, abdominal pain, nausea and vomiting.
He was admitted to the emergency department with hemodynamic instability with sinus tachycardia at 130x' and hypotension (AT: 80/50 mmHg) reason why he was admitted to the Intensive Care Unit.
On physical examination upon arrival to the ICU, the existence of a large abdominal disk stood out, with diffuse abdominal pain and extended left epigastric mass.
Blood tests showed leukocytosis with significant left shift, hyperglycemia, and a slight elevation in both bilirubin and liver enzymes.
After stabilization, an abdominal CAT scan showed a pancreatic pseudocyst of 17 x 8 cm in diameter that displaced the intestinal loops and compressed the stomach.
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Transgastric drainage was performed by means of echoendoscopy, but it was not possible because the compression exerted by the mass prevented the progression of the endoscope.
Likewise, several percutaneous drainage attempts were made, all of them being unsuccessful.
For this reason, it was decided to perform a surgical evacuation resulting in marupialization of the pseudocyst by cystogastrostomy obtaining a total of 4 purulent material.
The patient was discharged 6 days after admission.
