Pancreatic pseudocysts in children are not uncommon. Non-resolving pseudocysts often require surgical intervention. Endoscopic cystogastrostomy is a minimally invasive procedure which is recommended for this condition. We report a large pancreatic pseudocyst in a 4-year old child, which developed following therapy with PEG-Asparaginase for acute lymphoblastic leukemia. It was managed with minimally invasive procedure.
Various treatment options are available for the management of PP, such as open surgery, per-cutaneous drainage, laparoscopic and endoscopic cystogastrostomy. Initially, most patients are given a trial of non- operative management by maintaining good hydration, analgesia, prophylactic antibiotic coverage and parenteral or enteral nutrition in the hope that the PP may undergo spontaneous resolution. If its size is more than 5-6 cm and progressively increasing, as happened in our case, then the case for intervention becomes stronger.