What is a Pseudocyst?

A pseudocyst is a benign, fluid-filled pouch localized in the pancreas. Unlike a traditional cyst, a pseudocyst does not possess a well-defined membrane and is comprised of cells known to exist in other major organs. Individuals who have been diagnosed with an inflammation of the pancreas, known as acute pancreatitis, commonly develop pseudocysts. Treatment is generally unnecessary, unless the cyst increases in size or contributes to complications. Though rare, cyst rupture is considered a medical emergency requiring immediate attention.

Aside from its common association with acute pancreatitis, there are other situations which may contribute to the development of a pseudocyst. Individuals who have sustained trauma to their torso may be diagnosed with a pancreatic pseudocyst. Inflammation and swelling associated with pancreatitis may result in damage to the pancreatic tubes causing benign cyst development. Individuals with gallstones or those who consume excessive amounts of alcohol are at an increased risk of developing pancreatitis and pseudocysts.

Individuals with a benign cyst may be asymptomatic, meaning they may experience no symptoms at all. When symptoms develop, the person may exhibit a variety of signs. Abdominal bloating and discomfort during recovery from pancreatitis is usually indicative of pseudocyst development. Individuals experiencing digestive issues, including disrupted digestion, may be symptomatic of having a pseudocyst. Those who develop physical changes, including pronounced, unintended weight loss, weakness, or jaundice, may also be symptomatic.

A diagnosis confirming the presence of a pancreatic pseudocyst may involve the administration of a variety of diagnostic tests. During an initial examination, the attending physician will generally perform a physical examination and palpate the individual’s middle and upper abdomen to detect any swelling indicative of cyst development. Diagnostic imaging tests of the abdomen including a computerized tomography (CT) scan, ultrasound, or magnetic resonance imaging (MRI) may be performed.

Once a diagnosis has been confirmed, treatment may not be necessary. Pseudocysts which are small in size and not causing any secondary issues will generally dissolve independently. Surgical treatment is often reserved for cysts which are at least 0.2 inches (about 6 mm) in diameter in size and contribute to complication development.

The cyst may be drained through a variety of surgical methods. Guided-image technology, such as a CT scan, may be utilized to guide a hollow needle to the cyst allowing for percutaneous drainage through the skin. A thin tube outfitted with a tiny camera, known as an endoscope, may be employed to aid with the drainage process. A laparoscopic drainage procedure requires several small incisions in the abdomen and carbon dioxide gas, which is used to expand the abdominal cavity allowing for a better view of the target area. As with any medical procedure, surgical drainage procedures do carry some risk, including infection, excessive bleeding, and bowel obstruction.

Though uncommon, complications associated with pseudocysts do occur. Individuals with a pseudocyst that becomes infected should seek immediate medical attention. If left untreated, an infected cyst can develop into a pancreatic abscess, which may lead to a severe condition affecting the bloodstream, known as systemic inflammatory response syndrome (SIRS). A ruptured cyst is a medical emergency requiring immediate treatment to prevent hemorrhaging and shock, symptoms of which include an accelerated heart rate, severe abdominal discomfort, and impaired consciousness.