Learn About Pancreatic Pseudocyst

What is the definition of Pancreatic Pseudocyst?

A pancreatic pseudocyst is a fluid-filled sac in the abdomen that arises from the pancreas. It may also contain tissue from the pancreas, enzymes, and blood.

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What are the alternative names for Pancreatic Pseudocyst?

Pancreatitis - pseudocyst

What are the causes of Pancreatic Pseudocyst?

The pancreas is an organ located behind the stomach. It produces chemicals (called enzymes) needed to digest food. It also produces the hormones insulin and glucagon.

Pancreatic pseudocysts most often develop after an episode of severe pancreatitis. Pancreatitis happens when your pancreas gets inflamed. There are many causes of this problem.

This problem may sometimes occur:

  • In someone with long-term (chronic) swelling of the pancreas (pancreatitis), most often due to alcohol abuse
  • After trauma to the belly, more often in children

The pseudocyst happens when the ducts (tubes) in the pancreas are damaged and fluid with enzymes cannot drain.

What are the symptoms of Pancreatic Pseudocyst?

Symptoms can occur within days to months after an attack of pancreatitis. They include:

  • Bloating of the abdomen
  • Constant pain or deep ache in the abdomen, which may also be felt in the back
  • Nausea and vomiting
  • Loss of appetite
  • Difficulty eating and digesting food
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What are the current treatments for Pancreatic Pseudocyst?

Treatment depends on the size of the pseudocyst and whether it is causing symptoms. Many pseudocysts go away on their own. Those that remain for more than 6 weeks and are larger than 5 centimeters (about 2 inches) in diameter often need treatment.

Possible treatments include:

  • Drainage through the skin using a needle, most often guided by a CT scan.
  • Endoscopic-assisted drainage using an endoscope. In this, a tube containing a camera and a light is passed down into the stomach)
  • Surgical drainage of the pseudocyst. A connection is made between the cyst and the stomach or small intestine. This may be done using a laparoscope.
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What is the outlook (prognosis) for Pancreatic Pseudocyst?

The outcome is generally good with treatment. It is important to make sure that it is not a pancreatic cancer that starts in a cyst, which has a worse outcome.

What are the possible complications of Pancreatic Pseudocyst?

Complications may include:

  • A pancreatic abscess can develop if the pseudocyst becomes infected.
  • The pseudocyst can break open (rupture). This can be a serious complication because shock and excess bleeding (hemorrhage) may develop.
  • The pseudocyst may press down on (compress) nearby organs.
When should I contact a medical professional for Pancreatic Pseudocyst?

If you are known to have a pseudocyst, rupture of the pseudocyst is a medical emergency. Go to the emergency room or call the local emergency number (such as 911) if you develop symptoms of bleeding or shock, such as:

  • Fainting
  • Fever and chills
  • Rapid heartbeat
  • Severe abdominal pain
How do I prevent Pancreatic Pseudocyst?

The way to prevent pancreatic pseudocysts is by preventing pancreatitis. If pancreatitis is caused by gallstones, the provider will perform surgery to remove the gallbladder (cholecystectomy).

When pancreatitis occurs due to alcohol abuse, you must stop drinking alcohol to prevent future attacks.

When pancreatitis occurs due to high blood triglycerides, this condition should be treated.

Digestive system
Endocrine glands
Pancreatic pseudocyst - CT scan
Pancreas
What are the latest Pancreatic Pseudocyst Clinical Trials?
Immediate Necrosectomy vs. Step-up Approach After EUS-guided Drainage of Walled-off Necrosis: a Multicenter Randomized Controlled Trial (WONDER-01)

Summary: Walled-off necrosis (WON) is a pancreatic fluid collection, which contains necrotic tissue after four weeks of the onset of acute pancreatitis. Interventions are required to manage patients with infected WON, for which endoscopic ultrasonography (EUS)-guided drainage has become a first-line treatment modality. For patients who are refractory to EUS-guided drainage, the step-up treatment including ...

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Treatment of Pancreatic Pseudocysts by Endoscopic Ultrasound-guided Drainage

Summary: Patients may evolve pseudocysts of the pancreas secondary to a severe pancreatitis. In case of a symptomatic or infected pseudocyst, a therapeutic drainage of the cyst is indicated. In modern medicine the preferred way to perform such a drainage is by the means of endoscopic ultrasound (EUS). It is not precisely elucidated how this EUS-procedure should be performed in different scenarios. The cyst...

What are the Latest Advances for Pancreatic Pseudocyst?
Single balloon enteroscopy-guided endoscopic retrograde pancreatography for the treatment of a symptomatic pancreatic pseudocyst complicated by pancreaticojejunostomy stricture: A case report.
Endoscopic treatment of pancreaticopleural fistulas.
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A patient with autoimmune pancreatitis complicated by pancreatic pseudocyst that caused colonic perforation-induced gastrointestinal bleeding.
Who are the sources who wrote this article ?

Published Date: October 25, 2021
Published By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 135.

Martin MJ, Brown CVR. Management of pancreatic pseudocyst. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:525-536.

Vege SS. Acute pancreatitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 58.