The pseudocyst and pancreatic cyst is the result of localized accumulation of fluid, surrounded by a wall of fibrous tissue with or without epithelial lining.

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What is the difference between pseudocysts and pancreatic cysts and what causes them?

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Pseudocysts originate from rupture of the pancreatic duct, which allows pancreatic secretion to escape into the abdominal cavity. The body's defense is to isolate this irritating fluid with a wall of fibrous tissue. It presents as a complication of pancreatitis (acute or chronic) or after severe abdominal trauma.

Pacreatic cysts are benign or malignant tumors originating from the epithelium that produce fluid and/or mucus and hence the formation of the cyst. These can be located within the pancreas (intrapancreatic) or in the tissue surrounding the pancreas (extrapancreatic).

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Symptoms

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Symptoms occur in subjects with acute pancreatitis that does not resolve after 5-7 days of treatment, presenting with a foreign body sensation, heaviness in the upper half of the abdomen, and persistent pain.

Pseudocyst symptoms in chronic pancreatitis are more insidious and consist of a foreign body sensation in the abdomen, abdominal pain, and/or gastric compression symptoms such as nausea, vomiting, and weight loss.

The cysts give similar symptoms although in an even more insidious way and there is no history of pancreatitis.

Pseudocysts and cysts in turn can be complicated by bleeding, rupture, infection, occlusion of the bile duct or intestine.

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Current methods for diagnosis

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• Radiological examination (simple abdominal X-ray and contrast studies)

• abdominal ultrasound

• Computed Axial Tomography (CT)

• Endoscopic retrograde cholangiopancreatography (ERCP)

• Endoscopic Ultrasound (EUS)

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Treatment

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Treatment. Approximately 60% of pseudocysts (following acute pancreatitis) disappear spontaneously over time. Those that do not and are causing symptoms should be treated by draining them into the stomach or duodenum using endoscopic ultrasound, by endoscopic retrograde cholangiopancreatography (achieving drainage through the pancreatic duct), or by surgery.

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