Pancreatic pseudocyst

Definition
A pancreatic pseudocyst is a collection of tissue, fluid, debris, pancreatic enzymes, and blood that can develop after acute pancreatitis.

Causes, incidence, and risk factors

Pancreatic pseudocysts usually develop between one and four weeks after the onset of acute pancreatitis. They are often caused by a disruption of the pancreatic duct due the inflammation that occurs during pancreatitis. Risk factors for pancreatic pseudocyst are acute pancreatitis, abdominal trauma, and chronic pancreatitis.

Symptoms

     
  • Persistent Abdominal pain, may radiate to the back  
  • Abdominal mass  
  • Inability to eat

Signs and tests

The health care provider may palpate your abdomen to feel for a pseudocyst, which feels like a mass in the middle or left upper abdomen.

Tests that may help diagnose pancreatic pseudocyst include:

Treatment

Treatment depends upon the size and the condition of the pseudocyst. Many clear up on their own, although surgery is necessary in some cases.

Surgical methods include the following:

     
  • Percutaneous surgery: uses a needle, usually under radiological (X-ray) guidance  
  • Endoscopic-assisted drainage: uses an endoscope (a tube containing a camera device with a light) to locate the pseudocyst

Expectations (prognosis)

The outcome is good with treatment.

Complications

     
  • Rupture of the pseudocyst can be a serious complication - shock and hemorrhage may develop.  
  • A Pancreatic abscess can develop if the pseudocyst becomes infected.  
  • The pseudocyst may press on nearby organs.

Calling your health care provider

Call your health care provider if you develop persistent Abdominal pain or signs of Pancreatic abscess such as fever or chills.

Rupture of the cyst is an emergency situation! Go to the emergency room or call the local emergency number (such as 911) if symptoms occur that may indicate the onset of bleeding and shock, such as the following:

     
  • Fainting  
  • Severe Abdominal pain  
  • Decreased consciousness  
  • Rapid heartbeat

Prevention

Prevention of pancreatic pseudocysts is directed at preventing pancreatitis. If pancreatitis is caused by gallstones, treatment of the gallstones is necessary. When pancreatitis occurs due to Alcohol Abuse, the patient must stop consuming alcohol.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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