1. What is a pancreatic pseudocyst?
A pseudocyst is a fluid-filled sac containing pancreatic enzymes. They are common cysts found on and within the pancreas. Most do not cause symptoms nor are they cancerous. They often are discovered incidentally when patients undergo imaging tests such as a CT scan or abdominal ultrasound for other reasons.
2. Why do pancreatic pseudocysts develop?
Most pseudocysts have no known cause but some develop after a bout of pancreatitis, which may damage areas within the pancreas. Pseudocysts also may develop as a result of trauma to the abdomen or from hereditary conditions.
3. Do pancreatic pseudocysts have symptoms?
Not all pseudocysts cause symptoms. When they do, symptoms can include abdominal pain (from pressing on organs) that may radiate to the chest and upper back, nausea and vomiting, and the presence of a growth that can be felt within the upper abdomen.
A pseudocyst can become infected and cause intense abdominal pain, fever and a rapid pulse. A cyst also may burst and release pancreatic enzymes all at once. When this situation occurs, the enzymes can damage blood vessels and cause internal bleeding. Both infected and ruptured pseudocysts are medical emergencies that should be seen in the emergency department at once.
4. How are pancreatic pseudocysts diagnosed?
Pseudocysts are diagnosed with blood tests and imaging studies that include abdominal ultrasound, abdominal CT scan or MRI, ERCP with endoscopic ultrasound, or MRCP. Your gastroenterologist also can take a sample of cystic fluid with a fine needle passed through the ERCP. Pseudocyst fluid is tested for the presence of cancer cells and proteins produced by cancer cells.
5. How are pancreatic pseudocysts treated?
Most pseudocysts cause no symptoms and are not treated. However, when imaging studies have determined a pseudocyst's size and location, your gastroenterologist may request that you have regular follow-up scans performed to monitor its growth. If a pseudocyst is causing symptoms it can be drained or surgically removed.
In addition to its diagnostic role, endoscopic retrograde cholangiopancreatography (ERCP) is used therapeutically to treat disorders of the biliary tract, including pseudocysts. Once the pancreas is visualized - usually with a contrast dye that produces x-ray images viewed on a monitor - miniaturized surgical instruments are passed through the ERCP. The pseudocyst is then drained or surgically removed.
6. Can pancreatic pseudocysts recur once they are treated?
Pseudocysts can develop again if you have recurring pancreatitis. Acute and chronic pancreatitis are risk factors for the development of pseudocysts.