Objectives

To review the indications, normal post-procedure imaging appearance and complications of endoscopic cystogastrostomy for pancreatic collections.

Background

Pancreatic collections in a setting of acute or recurrent pancreatitis can be complex in presentation, diagnosis and management. Image guided endoscopic techniques for drainage are emerging as the first line therapeutic option as it avoids the need for open incision or external drainage, has a high success rate, low morbidity and mortality.

However, due to its limited view, difficult manoeuvring and steep learning curve endoscopic cystogastrostomy can present with rare but significant complications. In view of its frequent use, its important for the general radiologist to be aware of its normal imaging appearance and complications.

Imaging findings OR Procedure findings

We review normal post-intervention appearances and analyse imaging features of complications like perforation, haemorrhage, infection, stent blockage , migration and malposition.

Conclusion

Despite its rare complications, endoscopic drainage is preferred in most clinical scenarios and often augment surgical techniques. As we encounter them more frequently, we attempt to discuss what the general radiologist should know.