Posterior gastric perforation in a case of pancreatitis with pseudocyst

Acute pancreatitis has a number of complications. Stress related mucosal lesions in the gastrointestinal tract and pseudocysts are a few to name. Here by we present a case of a 37 yearold male patient who was admitted to the urology ward of our institute with a diagnosis of leftpyonephrosis. On evaluation a diagnosis of infected pancreatic pseudocyst was made. A surgical intervention was carried out where an external drainage of thepseudocyst was done instead of internal drainage as the patient developed intraop hypotension.As bile was seen in the drain postoperatively, an evaluation was done which led to a confirmed diagnosis of gastric perforation. There is no mention in the literature as to when a repair for gastric peroration in cases of pancreatic pseudocyst has to be carried out.In this case we carried out surgical intervention2 weeks postoperatively,but were unsuccessful in treating the patient. Hence we conclude that gastric perforation can be diagnosed post operatively in a case ofpseudocyst of pancreas, but if the patient is responding to a conservative line of treatmentit is better to delay the perforation closure.