| Summary: | When examining patients with chronic inflammatory pancreatitis, about 50% of them have pseudocysts. Bilocular pancreatic pseudocysts are rare clinical findings. This article presents a clinical observation that demonstrates the difficulties in the diagnosis and treatment of a 37-year-old patient with inflammatory chronic pancreatitis with a large (giant, more than 10 cm in size) bilocular pseudocyst of the pancreas. The pseudocyst was the outcome of sterile macrofocal pancreatic necrosis with a predominant lesion of the tail of the pancreas. It was diagnosed with computed tomography of the abdomen 1.5 months later after the end of the treatment of acute pancreatitis, the size of the pseudocyst was 4.8×7.3×22.0 cm. A special feature of the case is the occurrence of an internal cysto-colonic fistula. The choice of the method of surgical treatment is discussed taking into account the size of the pseudocyst, the time of its formation, the absence of signs of ductal hypertension of the pancreas and other complications of chronic pancreatitis. The use of external puncture drainage of the pseudocyst and the drug «Sandostatin LAR» made it possible to successfully complete the treatment of the patient using minimally invasive technologies.
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