What is a pancreatic pseudocyst?
A pancreatic pseudocyst is a collection of tissue and fluids that forms on your pancreas. Your pancreas is located behind your stomach.
Pseudocysts usually form as the result of a hard blow to your abdomen or an inflammation of the pancreas known as pancreatitis.
“Pseudo” means false. A pseudocyst looks 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 isn’t usually dangerous unless it ruptures. A ruptured pancreatic pseudocyst is a life-threatening condition. See your doctor immediately if you have any of the following symptoms:
- high, persistent fever
- severe pain in your upper abdomen, with pain radiating to your back
- unexplained fainting
- vomiting blood
- weak, rapid heartbeat
You should pay even closer attention to these symptoms if you or anyone in your family has had pancreatitis.
Pancreatic pseudocysts most often follow a bout of pancreatitis. Pancreatitis is a serious and painful condition. 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 your pancreas. Cysts typically form when the ducts that carry pancreatic juices to the intestine become blocked.
Pancreatitis can be either acute or chronic. Acute pancreatitis starts suddenly and it can go away with or without treatment. Chronic pancreatitis resists treatment.
While pancreatitis may be a complication of surgery or due to certain autoimmune disorders, alcohol use disorder is the most common cause of both acute and chronic pancreatitis. Additionally, alcohol use disorder can raise the level of certain fats, or triglycerides, in your bloodstream. Your pancreas helps your body digest fats but too much fat can damage it.
Pancreatitis can also be due to gallstones. These are pebblelike deposits that develop in your gallbladder. This small organ is located near your pancreas. It stores bile produced in your liver. Gallstones may be very small or they can grow as large as a golf ball. In some cases, they may block the ducts that drain your 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, doctors accidentally discover pancreatic pseudocysts when performing a CT or MRI scan to diagnose a different condition.
However, you should also watch for the following symptoms, especially if you’ve recently had pancreatitis or a blow to your torso:
- nausea and vomiting
- pain in the area of your upper abdomen, sometimes radiating to your back
- a lump you can feel in the area of your upper abdomen
- difficulty eating and digesting food
These symptoms can also indicate other conditions, including pancreatic cysts or cancerous tumors. Be sure to tell your doctor about all of 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 for emergency services immediately. A ruptured cyst can cause massive bleeding and infection in the abdomen that could be fatal.
If your doctor thinks you may have a pancreatic pseudocyst, they’ll order imaging tests 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 your abdomen and organs.
Your doctor will then insert a thin, flexible tube with a light and camera attached to it into your mouth and down into the upper part of your small intestine. This instrument is called an endoscope. 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 accident
- if you have gallstones
If your doctor determines that you have a pseudocyst but you don’t have any symptoms, they may suggest you wait to see if the cyst goes away on its own. Regular imaging tests can monitor the growth or shrinking of the cyst.
When a pseudocyst compresses your other organs, your doctor will need to drain it to reduce its size. It also needs draining if it grows so large that it could rupture. Drainage requires surgery under general anesthesia, meaning that you’ll be in a pain-free sleep 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, your doctor might make a larger incision to view the pseudocyst directly.
Your doctor will drain or suction out the contents of the pseudocyst. They’ll send a sample of the contents to a lab to test for infections and signs of cancer. You’ll receive antibiotics even if you don’t have an infection to make sure one doesn’t develop.
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 you have alcohol use disorder, consider stopping or seeking treatment, especially if you have a family history of alcohol use disorder or pancreatitis.
A diet low in carbohydrates and cholesterol and consisting of fresh fruits, vegetables, and lean protein can lower your triglycerides and help prevent the development of pseudocysts.
The outlook for someone with a pseudocyst is usually good if there’s no chance of rupture. Surgery to drain pseudocysts has a high recovery rate.