Pancreatic Cysts and Pseudocysts
What is a pancreatic cyst?
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).
What is a pancreatic pseudocyst?
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.
- Are health problems caused by acute or chronic pancreatitis (see below).
- Are caused by a blockage in the pancreatic ductal system.
- Are round or oval in shape.
- Are the most common pancreatic cystic lesions (about 75% to 80% of all pancreatic cystic lesions).
- Are benign (non-cancerous).
- Affect approximately 1 in 1,000 adults per year.
What is the pancreas?
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.
What is pancreatitis?
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.
What are the symptoms of pancreatic cysts or pseudocysts?
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:
- Severe, persistent pain in the abdomen and sometimes the back.
- Abdominal bloating.
What are the complications of pancreatic cysts/pseudocysts?
Rarely, complications can come from pancreatic cysts/pseudocysts, including:
- Infection, which can sometimes lead to pancreatic abscess.
- Pseudocyst rupture (breaking open) or hemorrhage (bleeding), which can
happen without warning and which can be life-threatening.
- Biliary complications, which can occur when a large cyst blocks the
common bile duct, causing skin, mucous membranes and whites of the eyes to
appear yellow (obstructive jaundice).
- Portal hypertension, or high blood pressure of the splenic vein/portal
vein, which requires surgery.