A pancreatic pseudocyst is a fluid-filled sac in the abdomen. It may also contain tissue from the pancreas, enzymes, and blood.
The pancreas is an organ located behind the stomach. It produces chemicals (called enzymes) needed to digest food. It also produces the hormones insulin and glucagon.
Pancreatic pseudocysts most often develop after an episode of sudden, severe pancreatitis. Pancreatitis is sudden swelling of the pancreas. There are many causes of this problem.
This problem may sometimes occur:
- In someone with chronic swelling of the pancreas
- After trauma to the belly, more often in children
The cyst happens when the ducts (tubes) in the pancreas are damaged and fluid with enzymes cannot drain.
Symptoms can occur within days to months after an attack of pancreatitis, and include:
- Bloating of the abdomen
- Constant pain or deep ache in the abdomen, which may also be felt in the back
- Difficulty eating and digesting food
Treatment depends on the size of the pseudocyst and whether it is causing symptoms. Many pseudocysts go away on their own. Those that remain for more than 6 weeks and are larger than 5 cm in diameter often need treatment.
Possible treatments include:
- Drainage through the skin using a needle, most often guided by a CT scan
- Endoscopic-assisted drainage using an endoscope (a tube containing a camera and a light that is passed down into the stomach)
- Surgical drainage of the pseudocyst, which involves making a connection between the cyst and the stomach or small intestine. This may be done using a laparoscope.
The outcome is generally good with treatment. It is important to make sure that it is not a pancreatic cancer that starts in a cyst, which has a worse outcome.
The way to prevent pancreatic pseudocysts is by preventing pancreatitis. If pancreatitis is caused by gallstones, it is often necessary to remove the gallbladder with surgery (cholecystectomy).
When pancreatitis occurs due to alcohol abuse, you must stop drinking alcohol to prevent future attacks.
When pancreatitis occurs due to high blood triglycerides, this condition should be treated.
Pancreatitis - pseudocyst
Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 144.
Forsmark CE, Baillie J. AGA Institute Technical Review on acute pancreatitis. Gastroenterology. 2007;132:2022-2044. PMID: 17484894 www.ncbi.nlm.nih.gov/pubmed/17484894.
Tenner SC, Steinberg WM. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 58.
Update Date 10/27/2015
Updated by: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.