HEPATOBILIARY · MEMBERSHIP SURGERY

Pancreatic pseudocyst — 6 weeks after severe AP

12 decision points ~24 min Difficulty 4/5 Membership

Setting

You are the on-call HPB fellow at Korle Bu. USS is bedside; CT is on call within two hours; MRCP runs Tuesday afternoons; therapeutic endoscopy is available with 24-hour notice.

Patient

Mr D, a 46-year-old lorry driver, was admitted six weeks ago with alcohol-induced severe acute pancreatitis. He was discharged after 12 days. He returns with a two-week history of dull epigastric pain, early satiety, 4 kg weight loss and a mass palpable in the epigastrium. He is afebrile. Amylase 142, WCC 8.1, albumin 32, bilirubin 14.

Reference stack

Bailey & Love 28e Ch 68 · Sabiston 21e Ch 55 · Blumgart 6e Ch 55 · Revised Atlanta Classification 2012 · ESGE 2020 pancreatic collections

Start cascade →

You'll be asked to decide what happens next at each step. There's no timer — take your time. The correct answer + evidence-anchored rationale is revealed after each choice.