PSEUDOCYST OF THE PANCREAS

Pseudocyst of the Pancreas

Abstract

Pancreatic pseudocysts are the most common cystic lesions of the pancreas, accounting for 75-80% of such masses. A pancreatic pseudocyst is a group of amylase-rich, lipase-rich, and enterokinase-rich fluid. It is most frequently located in the lesser peritoneal sac in proximity to the pancreas. Large pseudocysts can extend into the paracolic gutters; pelvis; mediastinum; and, rarely, the neck or scrotum. Some pseudocysts in the pancreatic parenchyma are loculated. The most common etiologies for pancreatic pseudocysts include chronic pancreatitis, acute pancreatitis, and pancreatic trauma. In addition, pseudocysts are associated with pancreatic ductal obstruction and pancreatic neoplasms.

Pseudocyst of the Pancreas

Introduction

A pancreatic pseudocyst is a collection of fluid around the pancreas. The fluid in the cyst is usually pancreatic juice that has leaked out of a damaged pancreatic duct. Pancreatic pseudocysts arise after acute pancreatitis or chronic pancreatitis. In some patients the pseudocyst may develop soon after an attack of acute pancreatitis. Often the patient can present many weeks or months after recovery from of an attack of acute or chronic pancreatitis. 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) (Sander et al. 2000). Alcoholism also contributes to the risk of pseudocysts of the pancreas. Other, rarer causes include abdominal trauma and gallbladder disease.

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

detectable, tender mass in the abdomen

jaundice - yellowing of the skin and eyes.

ascites - fluid build-up in the abdominal cavity.

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

Diagnose

The common symptoms that patients present are pain in the abdomen, the feeling of bloating or poor digestion of food, a deep ache in the abdomen or complications related to the pseudocyst such as infection of the pseudocyst with a pancreatic abscess, bleeding into the pseudocyst or blockage of parts of the intestine by the pseudocyst.

The diagnosis is usually made by a CT scan. A typical picture is seen on CT of a fluid filled mass around the pancreas. It is important to note that in some patients, cystic tumors such as mucinous cystadenoma may look exactly like a pseudocyst. An evaluation by an experience radiologist and a surgeon to evaluate the cyst is important for appropriate care? 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 which 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 cross-sectional images (often called slices), both horizontally and vertically, ...