A pancreatic pseudocyst is a collection of tissue and fluids that forms on your pancreas, an organ located behind your stomach. It is usually the result of pancreatitis (inflammation of the pancreas) or a hard blow to your abdomen.
Pseudo means “false.” A pseudocyst is shaped like a cyst but is made from different kinds of tissue than a true cyst. A true cyst is more likely to be cancerous than a pseudocyst.
A pancreatic pseudocyst is usually not dangerous unless it ruptures. A ruptured pancreatic pseudocyst, on the other hand, is a life-threatening condition. If you experience any of the following symptoms, go to an emergency room, or call 911:
- high, persistent fever
- severe pain in your upper stomach, with pain radiating to your back
- vomiting blood
- weak, rapid heartbeat
Pay especially close attention to these symptoms if you have pancreatitis in your personal or family medical history.
Pancreatic pseudocysts most often follow a bout of pancreatitis. Pancreatitis is a serious and painful condition in which pancreatic enzymes, which help you digest fats and sugars, overreact and begin to digest the tissues of the pancreas itself. This can cause swelling, bleeding, and damage to the tissues and blood vessels in the pancreas. Cysts typically form when the ducts that carry pancreatic juices to the intestine become blocked.
There are two types of pancreatitis: acute and chronic. Acute pancreatitis is sudden and can go away without treatment. Chronic pancreatitis resists treatment.
Causes of Pancreatitis
While pancreatitis may be a complication of surgery or caused by certain autoimmune disorders, alcoholism is the most common cause for this condition. According to the National Center for Biotechnology Information, 70 percent of pancreatitis cases in the U.S. are caused by alcoholism or alcohol abuse (NCBI, 2010).
Additionally, alcoholism can raise the level of certain fats (triglycerides) in your bloodstream. Your pancreas helps your body digest fats, but it can become damaged if there is too much fat to process. Your triglyceride level can also be higher-than-normal because of too much fat and cholesterol in your diet, or because you have diabetes or kidney disease.
Pancreatitis can also be caused by gallstones. These are pebble-like deposits that develop in the gallbladder, a small organ located near the pancreas that stores bile produced in the liver. Gallstones may be very small, or can grow as large as a golf ball. In some cases, they may block the ducts that drain the pancreas, causing pancreatitis to develop.
You can have a pancreatic pseudocyst with no symptoms at all. Sometimes, they even go away on their own. According to the Mayo Clinic, many pancreatic pseudocysts are found when a CT or MRI scan is performed to diagnose a different condition (Mayo Clinic, 2010).
However, you should also watch for these symptoms, especially if you’ve recently had pancreatitis or a blow to the torso:
- nausea and vomiting
- pain in the area of your upper stomach, sometimes radiating to your back
- a lump you can feel in the area of your upper stomach
- difficulty eating and digesting food
These symptoms can also indicate other conditions, including pancreatic cysts or cancerous tumors. Make sure to tell your doctor about all your symptoms.
A ruptured cyst may present different symptoms, such as:
- vomiting blood
- weak and rapid heartbeat
- severe abdominal pain
- decreased consciousness
If you experience any of these symptoms, seek emergency medical attention or call 911 immediately. A ruptured cyst can cause massive bleeding and infection in the abdomen, and could be fatal.
If your doctor thinks you may have a pancreatic pseudocyst, he or she will order imaging tests such as a CT scan or an MRI scan to get a better look at the structure of your pancreas and to gather more detailed information about the cyst.
Your doctor may also order an endoscopic ultrasound. This procedure uses high-powered sound waves to create an image of the abdomen and organs. Your doctor will then insert a thin, flexible tube with a light and camera attached to it (endoscope) into the mouth and down into the upper part of the small intestine. This procedure allows your doctor to gather a small amount of fluid from the cyst to determine if the mass is cancerous.
Your doctor may also ask you if you have a family history of pancreatitis, how much alcohol you drink, if you’ve recently been in a car crash, and if you have gallstones.
If your doctor determines that you have a pseudocyst, but you don’t have any symptoms, he or she may suggest you wait to see if the cyst goes away on its own. The growth or shrinking of the cyst can be monitored with regular imaging tests.
When a pseudocyst is pressing on other organs, it should be drained to reduce its size. It should also be drained if it’s grown so large that it could rupture. Drainage requires surgery under general anesthesia, meaning that you will be asleep and pain-free during the procedure.
Surgery involves making a very small incision to drain the pseudocyst with a needle guided by ultrasound or an endoscopic camera. Alternatively, the doctor might make a larger incision to view the pseudocyst directly.
The contents of the pseudocyst will be drained or suctioned out. A sample of the contents will be sent to a lab to test for infections and signs of cancer. You will be prescribed antibiotics even if you don’t have an infection, to make sure one doesn’t develop.
The outlook for someone who has a pseudocyst is usually good, as long as there is no chance of rupture. Surgery to drain pseudocysts has a high recovery rate.
Pancreatitis is the most common cause of pseudocysts, so preventing pancreatitis is the best way to prevent cysts from forming. If you drink alcohol regularly or are an alcoholic, consider stopping or seeking out treatment for addiction, especially if you have a family history of alcoholism or pancreatitis.
A diet low in carbohydrates and cholesterol, and consisting of fresh fruits, fresh vegetables, and lean protein, can lower your triglycerides and help prevent the development of pseudocysts.