TRANSDIAPHRAGMATIC CYST - JEJUNOSTOMY WITH ROUX-EN-Y LOOP FOR AN EXCLUSIVELY MEDIASTINAL PANCREATIC PSEUDOCYST

In a patient presenting with a roentgenographic retrocardiac density, left pleural effusion and distal oesophageal displacement, echocardiog raphy confirmed presence of a pseudocyst in the posterior mediastinum. Pancreatic origin was suspected. Left thoracolaparotomy revealed the large (900 ml), exclusively mediastinal pseudocyst, surrounding the ao rta and adherent to the diaphragm, with high amylase content. Decompre ssion was achieved with a retrocolic and gastric Roux-en-Y loop by tra nsdiaphragmatic cystojejunostomy.