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home - Pancreas - Pancreatic Masses and Cysts - Pseudocyst Epidemiology Written by Dr Sebastian Zeki

Pseudocyst Epidemiology

DefinitionIt is a maturing collection of pancreatic juice >4 weeks old.It is encased by reactive granulation tissue (therefore not a true cyst).It occurs in or around the pancreas.It is as a consequence of inflammatory pancreatitis or ductal leakage.It can be single or multiple.It can be small or large.Most pseudocysts communicate with the pancreatic ductal system and contain high concentrations of digestive enzymes. Pancreatic Pseudocysts Epidemiology Non-communicating Communicating Types of pseudocyst: The walls of pseudocysts are formed by -Stomach-Transverse mesocolon-Gastrocolic omentum-Pancreas Aetiologies:-Acute pancreatitis (10%).(from liquefied necrosis organizing into a pseudocyst).-Parenchymal necrosis causing complete ductal destruction.-Chronic pancreatitis pseudocysts are due to an acute attack or progressive ductal destruction from strictures/ stones.-Blunt or penetrating trauma causing ductal disruption. Clinical Manifestations:Abdominal pain.Problems related to complications.Sepsis (if secondarily infected). Complications:Duodenal obstruction.Biliary obstruction.Vascular occlusion/ digestion (causing pseudoaneurysm (in 10%)/ bleeding into pseudocyst/ GI bleeding or haemosuccus pancreaticus(=bleeding into pancreatic duct)).Fistula formation into adjacent viscera, the pleural space, or pericardium. DiagnosisThis is usually radiological.If EUS and FNA, amylase will be high if communicates with pancreatic duct (>1000 IU/L). Written by Dr Sebastian Zeki

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