Pancreatic Pseudocyst Following Spinal Surgery: Always Think About It-A Case Report.

Aim: To report the conservative management of a pancreatic pseudocyst (PP) following spinal surgery for neurogenic scoliosis in a pediatric patient.

Case presentation: A 12-years-old girl presented with spinal arthrodesis and lumbar fixation for neurogenic scoliosis secondary to cerebral palsy (CP). On postoperative day 11, abdominal computed tomography (CT) showed accumulated fluid (74 × 52 mm) extending along the greater gastric curvature, from the left liver lobe to the anterior abdominal wall.

Results: The fluid was percutaneously drained. The fluid contained a high concentration of amylase; therefore, a diagnosis of PP was made. After 23 days, the symptoms progressively resolved, and the accumulated fluid disappeared. Gastrointestinal complications following spinal surgery in patients with CP are reported in 5%-55% of cases; among these, PP is extremely rare. Pancreatic postoperative ischemia or pancreatic iatrogenic trauma are possible causes of PP formation. In our case, conservative management was safe and effective.

Conclusions: In patients with persistent postoperative abdominal symptoms following spinal surgery, pancreatic complications should be ruled out. If PP is diagnosed, conservative management is recommended, particularly in young patients with a poor general condition.