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 abdomen. Pancreatitis is most commonly caused by alcohol abuse and gallstones. Pseudocysts are often asymptomatic. Symptoms are more common in larger pseudocysts, though the size and time present usually are poor indicators of potential complications.
- Loss of appetite
- Weight loss
- A tender mass in abdomen
- Yellowing of the skin and eyes (jaundice)
- Fluid buildup in the abdominal cavity
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.
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.
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Dr. Ujwal Zambare
MBBS, MS (General Surgery), DNB (Gastrointestinal Surgery)
Fellowship in Minimal Access Surgery
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