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Background  Mediastinal pancreatic pseudocyst is a rare complication of acute or chronic pancreatitis.    Case presentation  This case report describes the management of a difficult case of pancreatic pseudocyst with a mediastinal extension in a patient having chronic pancreatitis. Different management strategies were used until complete resolution of this complex pseudocyst occurred using open surgical cystogastrostomy.    Conclusion  Despite the availablity of different minimally invasive techniques to treat pancreatic pseudocysts, management of complex mediastinal pseudocyst may still require open surgical drainage procedures.

Mediastinal extension of a complicated pancreatic pseudocyst; a case report and literature review