Pseudocysts of the Pancreas

What are pseudocysts of the pancreas?

Pseudocysts of the pancreas are abnormal collections of fluid, dead tissue, pancreatic enzymes, and blood that can lead to a painful mass in the pancreas. Pseudocysts usually develop several weeks after an episode of acute pancreatitis (a sudden, painful inflammation of the pancreas). Alcoholism also contributes to the risk of pseudocysts of the pancreas. Other, more rare causes include abdominal trauma and gallbladder disease.

What are the signs and symptoms of pseudocysts of the pancreas?

The following are the most common symptoms of pseudocysts of the pancreas. However, each individual may experience symptoms differently. Symptoms may include:

• Abdominal pain

• Nausea

• Vomiting

• Poor appetite

• Weight loss

• Diarrhea

• Fever

• Abdominal mass. The abdomen will be tender and swollen.

• Jaundice. A yellowing of the skin and eyes.

• Ascites. Fluid buildup in the abdominal cavity.

The symptoms of pseudocysts of the pancreas may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How are pseudocysts of the pancreas diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for pseudocysts of the pancreas may include the following:

• Blood tests

• Chest x-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

• Computed tomography scan (CT or CAT scan). A diagnostic imaging procedure using a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

• Ultrasound (also called sonography). A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen, and kidneys and to assess blood flow through various vessels.

• Endoscopic retrograde cholangiopancreatography (ERCP). A procedure that allows the doctor to diagnose and treat problems in the liver, gallbladder, bile ducts, and pancreas. The procedure combines X-ray and the use of an endoscope, which is a long, flexible, lighted tube. The scope is guided through the patient's mouth and throat, then through the esophagus, stomach, and duodenum. The doctor can examine the inside of these organs and detect any abnormalities. A tube is then passed through the scope, and a dye is injected which will allow the internal organs to appear on an X-ray.

What are treatments for pseudocysts of the pancreas?

Specific treatment for pseudocysts of the pancreas will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the disease

• Your tolerance of specific medicines, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

The goal for treatment of a pancreatic pseudocyst is to monitor its growth and to treat it surgically if it grows, or if there is risk for complications.

Treatment may include:

• Close monitoring by scans (to determine any change in size)

• Surgical drainage of the cyst(s)

• Endoscopic drainage of the cyst (using an instrument called an endoscope, which has a tiny light and camera to locate the cyst)

• Percutaneous (through the skin) drainage of the cyst using a needle (guided by a CT scan)

If left untreated or unmonitored, pseudocysts can rupture, causing extreme pain, blood loss, and infection.