What is a Pancreatic Pseudocyst?

D. Jeffress

A pancreatic pseudocyst is a mass of tissue and fluid that forms in the abdominal cavity following a bout of pancreatitis. Depending on the size and number of pseudocysts present, an individual may experience abdominal pain, anorexia, or a palpable mass in the lower abdomen. A doctor may choose to leave a pancreatic pseudocyst untreated if it does not cause adverse symptoms, but a mass that leads to significant discomfort may need to be drained via a special surgical procedure.

A physician should monitor large pancreatic pseudocysts that may be painful or indicate other health concerns.
A physician should monitor large pancreatic pseudocysts that may be painful or indicate other health concerns.

Pseudocysts are usually the result of acute pancreatitis, a condition most closely associated with alcohol abuse and gallbladder disease. Inflammation and swelling of the pancreas causes blockages in the pancreatic ducts, which leads to the buildup of enzymes, blood, and stray tissue that eventually form a pancreatic pseudocyst. A pseudocyst may also occur with a severe infection, direct trauma to the abdomen, or an autoimmune disorder.

The pancreas gland aids in digestion and produces insulin.
The pancreas gland aids in digestion and produces insulin.

A person may have a single pancreatic pseudocyst or multiple, smaller masses in the abdominal cavity. Some pseudocysts do not cause symptoms and dissipate naturally after a few weeks, though persistent masses can cause chronic pain, tenderness, and internal swelling. A person may even be able to feel the pseudocyst by pressing on his or her abdomen. Some people find themselves unable to eat, which can lead to anorexia and malnutrition.

A pancreas that is not performing correctly may cause bloating and watery stools.
A pancreas that is not performing correctly may cause bloating and watery stools.

A physician can perform a set of diagnostic imaging scans to detect and diagnose a pancreatic pseudocyst. When initial results from computerized tomography scans and ultrasounds show an abnormal fluid collection, the doctor usually refers the patient to a gastroenterologist for a more careful inspection. The specialist might insert an endoscopic camera to get a better view of the pseudocyst and collect a piece of tissue for laboratory analysis. Biopsy results can be used to confirm a diagnosis and rule out other conditions, including cancer.

An ultrasound can be used to detect pancreatic inflammation.
An ultrasound can be used to detect pancreatic inflammation.

Small, isolated pseudocysts that do not appear to cause health problems are often left alone. It is possible, however, for a pancreatic pseudocyst to become infected or rupture if it is left untreated. A suspicious pseudocyst can be drained by inserting a long needle attached to a catheter directly into the abdomen. With the aid of an endoscope, a surgeon locates the mass, punctures it, and drains the fluid into the catheter. More invasive surgical procedures may be necessary if multiple pseudocysts exist.

Pancreatic pseudocysts may trigger anorexia in some people.
Pancreatic pseudocysts may trigger anorexia in some people.

Following surgery, a patient is usually instructed to schedule regular checkups with his or her gastroenterologist. It is unlikely that a pancreatic pseudocyst will return, but an infection or underlying pancreatitis may still persist. The specialist can conduct imaging tests and prescribe antibiotics as needed to help prevent future health problems.

Acute pancreatitis, which is a common cause of pseudocysts, is commonly associated with alcohol abuse.
Acute pancreatitis, which is a common cause of pseudocysts, is commonly associated with alcohol abuse.
If multiple pancreatic pseudocysts exist, surgery may be necessary.
If multiple pancreatic pseudocysts exist, surgery may be necessary.

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