Pancreatic pseudocysts are abnormal cyst-like collections of fluid, dead
tissue, pancreatic enzymes, and blood that form in or around the
pancreas as a result of inflammation or injury. Pancreatic pseudocysts
most often develop as a complication of acute or chronic pancreatitis.
They also may occur after blunt trauma to the pancreas or pancreatic
Many pancreatic pseudocysts resolve without treatment. However, some can
cause serious problems, including significant abdominal pain, major
infection, or other complications.
Pancreatic pseudocysts sometimes are detected during an evaluation for
acute or chronic pancreatitis, abdominal pain, or a problem unrelated to
the pancreas. If a pseudocyst is suspected based on symptoms or other
factors, the diagnosis can be confirmed with an endoscopic
ultrasound examination. During the evaluation, a tiny needle is used
to collect fluid for analysis. Pseudocysts need to be differentiated
from pancreatic cysts and
other abnormalities that are treated differently.
The goal of treatment is to monitor the pseudocyst and drain it if
starts to cause symptoms, grows, or causes infection. If not monitored
and treated, pseudocysts can rupture, causing severe pain, blood loss,
and complications. Treatment options include:
Surgical drainage. Until recently, surgical
drainage was the only option, and it is still considered the
most appropriate option in some cases. With this approach, a
connection is made between the cyst and the digestive tract so
the cyst fluid can drain into the digestive system and be
eliminated. The surgical procedure varies depending on where the
cyst is located.
Endoscopic drainage. With this approach,
pancreatic pseudocysts are evaluated and drained with the use of
an upper endoscope equipped with specialized tools. The most
frequent approach is placement of a stent that allows the cyst
to drain into the digestive tract.
Percutaneous drainage. With this approach,
pancreatic pseudocysts are drained to the outside of the body.
An interventional radiologist places a drainage tube through the
skin and into the cyst.
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