Pancreatic cysts and pseudocysts are growths in the pancreas. Symptoms may include nausea, abdominal bloating and pain. Cysts and pseudocysts should be treated to avoid complications such as rupture or infection.
A pancreatic cyst is a closed sac lined with epithelium and located on or in your pancreas (see below). Pancreatic cysts contain fluid. They can range from benign pseudocysts to malignant cysts (cancerous and spreading). There are several different types of pancreatic cysts. Some pancreatic cysts result from certain rare diseases, such as von Hippel-Lindau disease (a genetic disorder).
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A pancreatic pseudocyst is a type of cyst that it is not contained inside an enclosed sac of its own with an epithelium lining. Instead, the pseudocyst forms within a cavity or space inside the pancreas and is surrounded by fibrous tissue. Pancreatic pseudocysts do contain inflammatory pancreatic fluid (particularly the digestive enzyme amylase) or semisolid matter.
Your pancreas is a 6-inch gland located below your liver, between your stomach and your spine. The pancreas is made up of three parts: a "head" that is tucked into the duodenum (the upper part of the small intestine); a flattened, longer "body;" and a "tail" that is connected to the spleen.
Your pancreas makes potent digestive enzymes and hormones that help manage blood glucose (blood sugar). Normally, these enzymes and hormones don't become active until they exit the pancreas and enter other parts of the body.
Your pancreas also produces bicarbonates that neutralize stomach acids. Small ducts (tubes) move these fluids into a larger pancreatic duct, down into the duodenum. The common bile duct also carries bile (a substance that breaks down fats) from your liver and gall bladder through the head of the pancreas into your small intestine.
An inflammation of the pancreas is called pancreatitis. Pancreatitis can either be acute (a sudden, sharp, and/or severe attack) or chronic (recurring and/or lasting for a long period of time). When the pancreas is inflamed, digestive enzymes become activated while still inside the pancreas, which can cause the pancreas to begin "digesting" its own tissues.
The two most common causes of pancreatitis are gallstones (bile that has hardened into little pebble-like masses) and chronic, heavy alcohol use. Pancreatitis can also result from certain diseases or injury. Pancreatic pseudocysts can develop as a serious complication of pancreatitis.
Pancreatic cysts, including pseudocysts, can be asymptomatic (having no obvious symptoms) or can produce moderate to severe symptoms. Symptoms may occur within days to months following a pancreatitis attack. The most common symptoms include:
Rarely, complications can come from pancreatic cysts/pseudocysts, including:
Pancreatic pseudocysts can be hard to diagnose because the symptoms can be similar to various other diseases. Since the pancreas is located deep inside the abdominal cavity, cross-sectional imaging is often used to locate and diagnose pancreatic cysts and pseudocysts.
Testing may include the following:
Most pseudocysts resolve on their own without treatment, over time. However, when symptoms become persistent, complications emerge or a cyst become larger than 6 centimeters in size, it should be drained.
There are three methods of cyst drainage:
Endoscopic drainage is gaining acceptance because it's less invasive, has less risk of complications than open surgery, doesn't require an external drain, and its long-term success rate is high.
Pseudocysts should be drained when they are causing symptoms. Some cysts require surgical removal if there is a concern for cancer or a precancerous condition.
In most cases, the prognosis is good for people who undergo treatment for pancreatic cysts and pseudocysts.
Last reviewed by a Cleveland Clinic medical professional on 07/29/2020.
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