Indu Lata and Sameer Mohindra
Sanjay Gandhi Postgradute Institute of Medical Sciences, Lucknow, UP, India
Posters & Accepted Abstracts: Gynecol Obstet
Pancreatic pseudocyst in pregnancy is a rare condition whose management is not standardized. We are reporting one rare case report along with critical review of twelve others published in the literature since 1980. A 23-year-old primigravida woman at 25 weeks' gestation presented with history of nausea, vomiting, and intermittent epigastric pain for last six months. She had past history of similar pain, five years back and diagnosed to have cystic lesion in pancreas without pancreatitis. Seven months back, the patient conceived and pregnancy was confirmed by urine pregnancy test and ultrsonography (USG). At 25 weeks gestation, patient again developed similar pain, for which she was admitted. On admission USG abdomen showed pseudopancreatic cyst 5.5 x 5.9 cm with internal echoes within. Her temperature was 100.6°F, pulse rate 110 beats/ min, and blood pressure 90/54 mm Hg. On examination, she was found to have a soft but distended abdomen with normal bowel sounds. The patient declined drainage of the pseudocyst because of the potential risk of preterm labor. She was treated conservatively with bowel rest, intravenous fluids, and parenteral nutrition. On antepartum USG fetus had intrauterine growth retardation and oligohydramnios with normal umbilical artery doppler parameters. Her abdominal pain was resolved after 5 days of conservative management and her diet was advanced after a week. She was started on oral amino acid tablets and high protein diet. Patient was discharged after 10 days of admission from the hospital. She developed preterm labor at 28 weeks that responded with tocolytics treatment. Due to illness and poor intake patient became anemic.To increase the hemoglobin level she was administered intravenous iron sucrose. At 33 weeks gestation on USG previously present pseudopancreatic cyst was absent. At 38.3 weeks pregnancy abdominal ultrasound shown asymptomatic incidental cholilithiasis along with fetal intrauterine growth restriction having breech presentation with oligohydramnios. Emergency caesarean section was done and an alive healthy female baby of 1400 gm was delivered. Patient was discharged with baby on breast feeding after one week of the cesarean section in stable condition.
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