4 CONCLUSION AND RESULTS (OUTCOME AND FOLLOW UP)
The patient presented after 1 month with a history of postoperative
fever, vomiting, and fever. A Follow-up CT scan was performed which
showed an interval decrease in the size of the peripancreatic pseudocyst
with interval development enhancing thick walls along with surrounding
fat stranding suggesting infection (Figure 4).
The patient was transfused 2-pack cell volume (PCV) due to low
hemoglobin and admitted to the ward for further management. Intravenous
(IV) fluids and antibiotics were continued. An ultrasound-guided drain
was placed in the pseudocyst cavity and 120 ml of infected fluid was
aspirated. Subsequently, the patient tolerated oral nutrition and was
afebrile and clinically stable before being discharged.
Pancreatico-renal fistula is a rare but potentially serious complication
of pancreatitis. Early recognition and appropriate management are
crucial to prevent complications and improve outcomes. This case
highlights the importance of a multidisciplinary approach involving
gastroenterologists, radiologists, and surgeons in the management of
pancreatic pseudocysts. Further research is needed to better understand
the pathophysiology and optimal management strategies for this uncommon
condition.