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Pseudocyst Epidemiology
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Written by Dr Sebastian Zeki
MCQs for this page
Pseudocyst Epidemiology
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Definition
It 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.
Diagnosis
This 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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