case_images: PMC10794364_01
case_images: Preoperative CT. Pancreatic pseudocyst measuring 9.8*7.6*9.0 cm.
case_images: fsurg-10-1323704-g001.jpg
case_images: PMC10794364_01_fsurg-10-1323704-g001.jpg
case_images: F1
case_images: He had been hospitalized for acute pancreatitis 4 years ago, and the results of abdominal CT examination after admission showed: a cystic mass on the right side of the middle and upper abdomen, considering the possibility of pancreatic pseudocyst; fatty liver (Figure 1).
case_images: Intraoperative images and procedures: (A) pseudocyst was closely adhered to the posterior gastric wall. (B) Sleeve gastrectomy was performed. (C,D) Ultrasonic scalpel was used to incise the pseudocyst, and at the same time, the jejunum was lifted and anastomosed with the cyst.
case_images: fsurg-10-1323704-g002.jpg
case_images: PMC10794364_01_fsurg-10-1323704-g002.jpg
case_images: F2
case_images: It was found that the posterior wall of the stomach was strongly adhered to the pancreas (Figure 2A). After careful separation of the adhesions, the greater curvature of the stomach and pancreatic pseudocyst were exposed, and a gastric sleeve resection was performed under the guidance of a 32 Fr bougie tube (Figure 2B). Treitz ligament, and Broun anastomosis was performed with the pseudocyst (Figures 2C,D), and the operation was completed. The operation time was 376 min and the amount of bleeding during surgery was 50 ml.
case_images: Postoperative CT of abdomen. Resolution of pseudocyst, but with regional portal hypertension.
case_images: fsurg-10-1323704-g003.jpg
case_images: PMC10794364_01_fsurg-10-1323704-g003.jpg
case_images: F3
case_images: However, an abdominal CT scan of the patient showed splenomegaly and multiple varicose veins in the fundus of the stomach, around the hilum of the spleen, and in the upper abdomen, as shown in Figure 3.