What Is a Pancreatic Pseudocyst?

The pancreas -- a spongy, tadpole-shaped organ located behind the stomach -- makes enzymes our bodies need to digest food and hormones to regulate blood sugar levels. If the pancreas is injured, its ducts, which carry enzyme-containing juices, can become blocked. This can lead to the development of a fluid-filled sac called a pancreatic pseudocyst.

A pseudocyst isn't a true cyst, because the wall of the sac is not composed of a specific lining of cells characteristic of a true cyst.

The most common cause of a pancreatic pseudocyst is inflammation of the pancreas, called pancreatitis. A less common cause or contributor is trauma, such as a blow to the abdomenPancreatitis is most commonly caused by alcohol abuse and gallstones.

Here's what you need to know about pseudocysts and their treatment.

Pseudocyst Symptoms

Although the symptoms of pseudocysts may be different for different people, some of the most common are abdominal pain and bloating.

Other symptoms may include:

If you have any of these symptoms, you should see your doctor to determine the cause.

Pseudocyst Diagnosis

Pseudocysts are usually diagnosed with a CT scan, an imaging procedure that uses a combination of X-rays and computer technology to create images of the inside of the body. These scans, which provide more detail than general X-rays, can show abnormalities of the pancreas and surrounding area.

Other tests that may be used in the workup of a pseudocyst include:

Blood tests. These tests measure levels of certain substances in the blood. For example, tests showing high levels of amylase or lipase, enzymes produced by the pancreas, may indicate inflammation of the pancreas.

Ultrasound (sonography). This is a technique that uses high-frequency sound waves to view internal structures, including the organs of the abdomen.

Endoscopic Retrograde Cholangiopancreatography (ERCP). This is a procedure combining X-ray and the use of an endoscope -- a long, lighted tube that is guided down the patient's throat through the stomach and upper end of the small intestine -- to view and diagnose problems with the digestive organs, including the pancreas.

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Pseudocyst Treatment

Often pseudocysts get better and go away on their own. If a pseudocyst is small and not causing serious symptoms, a doctor may want to monitor it with periodic CT scans. If the pseudocyst persists, gets larger, or causes pain, it will require surgical treatment. If not monitored or treated, a pseudocyst can become infected or rupture, causing severe pain, blood loss and abdominal infection.

Surgery for Pseudocysts

For pseudocysts requiring treatment, surgery may be necessary. During surgery to correct a pseudocyst, the surgeon usually makes a connection between the pseudocyst and a nearby digestive organ. This allows the pseudocyst to drain through that organ. Depending on the location of the pseudocyst within the pancreas, that connection may be with the stomach or small intestine.

In some cases, this surgery is done laparoscopically. That means it's performed through small incisions in the abdomen, using slender tools and a lighted scope. This procedure minimizes hospitalization and recovery time.

Draining a Pseudocyst

In other cases, treatment involves draining the pseudocyst without surgery. This can be done by a radiologist or gastroenterologist, a doctor specializing in the digestive system.

A radiologist will drain it by inserting a needle guided by computed tomography. A gastroenterologist may drain the pseudocyst through the stomach by creating a small opening between the pseudocyst and the stomach, or by placing a stent into the pancreas during endoscopy. If the stent is placed directly into the pseudocyst then the fluid from the pseudocyst is drained into the intestine through this tube.

Treatment varies for different people and different situations. If you have been diagnosed with a pseudocyst, speak with your doctor about the best treatment for you.

WebMD Medical Reference Reviewed by Louise Chang, MD on January 17, 2018

Sources

SOURCES:

University of Southern California Department of Surgery Center for Pancreatic and Biliary Diseases: "Pancreatic Pseudocysts."

University of Maryland Medical Center: "Pancreatic pseudocyst -- Overview."

New York-Presbyterian Hospital: "Pseudocysts of the Pancreas."

Cissé, M. Cases Journal, Jan. 11, 2010. 

Johns Hopkins Medicine: "Pancreatic Pseudocyst."

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