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A pseudocyst is a fluid-filled sac in the pancreas that can develop after acute pancreatitis, trauma, or other factors. Treatment is usually unnecessary unless the cyst grows or causes complications. Diagnosis involves imaging tests, and surgical drainage may be necessary for larger cysts. Complications can include infection, abscess, and rupture, which requires immediate treatment.
A pseudocyst is a benign, fluid-filled sac located in the pancreas. Unlike a traditional cyst, a pseudocyst does not have a well-defined membrane and is composed of cells known to exist in other major organs. Individuals who have been diagnosed with inflammation of the pancreas, known as acute pancreatitis, commonly develop pseudocysts. Treatment is usually unnecessary, unless the cyst increases in size or contributes to complications. Although rare, a ruptured cyst is considered a medical emergency that requires immediate attention.
In addition to its common association with acute pancreatitis, there are other situations that can contribute to the development of a pseudocyst. Individuals who have sustained trauma to the torso may be diagnosed with a pancreatic pseudocyst. The inflammation and swelling associated with pancreatitis can cause damage to the pancreatic tubes causing benign cysts to develop. Individuals with gallstones or those who consume excessive amounts of alcohol are at a higher risk of developing pancreatitis and pseudocysts.
Individuals with a benign cyst may be asymptomatic, meaning they may not experience any symptoms. As symptoms develop, the person may show a variety of signs. Abdominal bloating and discomfort during recovery from pancreatitis are usually indicative of pseudocyst development. Individuals who experience digestive problems, including disrupted digestion, may be symptomatic of having a pseudocyst. Those who develop physical changes, including pronounced and involuntary weight loss, weakness, or jaundice, may also be symptomatic.
A diagnosis that confirms the presence of a pancreatic pseudocyst may involve the administration of a variety of diagnostic tests. During an initial exam, the treating physician will typically perform a physical exam and palpate the individual’s mid and upper abdomen for any swelling indicative of developing cysts. Imaging tests of the abdomen including a computed tomography (CT), ultrasound, or magnetic resonance imaging (MRI) may be done.
Once the diagnosis is confirmed, treatment may not be necessary. Pseudocysts that are small and cause no secondary problems usually resolve on their own. Surgical treatment is often reserved for cysts that are at least 0.2 inch in diameter (about 6 mm) and contribute to the development of complications.
The cyst can be drained through a variety of surgical methods. Image-guided technology, such as a CT scan, can be used to guide a hollow needle to the cyst allowing for percutaneous drainage through the skin. A thin tube fitted with a tiny camera, known as an endoscope, may be used to assist in the drainage process. A laparoscopic drainage procedure requires several small incisions in the abdomen and carbon dioxide gas, which is used to expand the abdominal cavity allowing for a better view of the target area. As with any medical procedure, surgical drainage procedures carry certain risks, including infection, excessive bleeding, and intestinal obstruction.
Although uncommon, complications associated with pseudocysts do occur. Individuals with a pseudocyst that becomes infected should see a doctor right away. If left untreated, an infected cyst can develop into a pancreatic abscess, which can lead to a serious condition that affects blood flow, known as systemic inflammatory response syndrome (SIRS). A ruptured cyst is a medical emergency that requires immediate treatment to prevent bleeding and shock, symptoms of which include a rapid heartbeat, severe abdominal discomfort, and impaired consciousness.
