Pancreatic Pseudocyst with Intracystic Lithiasis, A Rare Cas Report

Pancreatic pseudocysts are encapsulated collections of enzyme-rich pancreatic fluid surrounded by a fibrous or granulation tissue wall, typically developing at least four weeks after an episode of acute pancreatitis or in the setting of chronic ductal obstruction. The presence of pancreatolithiasis—stones within the pancreatic duct or cyst cavity—adds diagnostic and therapeutic complexity by perpetuating ductal obstruction, increasing intraductal pressure, and promoting inflammation, thereby raising the risk of complications such as infection or hemorrhage.We report the case of a 52-year-old woman with a history of recurrent acute pancreatitis who presented with persistent upper abdominal pain. Contrast-enhanced computed tomography revealed a large, well-defined pseudocyst located in the pancreatic body, measuring 8 cm in maximal diameter, associated with mild upstream ductal dilatation and no evidence of necrosis.After resolution of the acute inflammatory phase, the patient underwent laparoscopic cystogastrostomy. Intraoperatively, an intracystic stone was identified and successfully extracted. Adequate internal drainage was achieved without the need for external drainage.The postoperative course was uneventful. Oral intake was resumed on postoperative day 2, and the patient was discharged on day 5. At 12-month follow-up, she remained asymptomatic, with no radiological recurrence. Histopathological examination confirmed a pseudocyst wall without epithelial lining, consistent with chronic pancreatitis.