Pancreatic pseudocyst

Abstract

Pancreatic pseudocysts are complications of acute or chronic pancreatitis. Initial diagnosis is accomplished most often by cross-sectional imaging. Endoscopic ultrasound with fine needle aspiration has become the preferred test to help distinguish pseudocyst from other cystic lesions of the pancreas. Most pseudocysts resolve spontaneously with supportive care. The size of the pseudocyst and the length of time the cyst has been present are poor predictors for the potential of pseudocyst resolution or complications, but in general, larger cysts are more likely to be symptomatic or cause complications. The main two indications for some type of invasive drainage procedure are persistent patient symptoms or the presence of complications (infection, gastric outlet or biliary obstruction, bleeding). Three different strategies for pancreatic pseudocysts drainage are available: endoscopic (transpapillary or transmural) drainage, percutaneous catheter drainage, or open surgery. To date, no prospective controlled studies have compared directly these approaches. As a result, the management varies based on local expertise, but in general, endoscopic drainage is becoming the preferred approach because it is less invasive than surgery, avoids the need for external drain, and has a high long-term success rate. A tailored therapeutic approach taking into consideration patient preferences and involving multidisciplinary team of therapeutic endoscopist, interventional radiologist and pancreatic surgeon should be considered in all cases.

Somatostatine analogue in nonoperative treatment of posttraumatic pancreatic pseudocyst in a child: a case report

“…CT scan is the investigation of choice which demonstrates the presence of thick walled, cystic lesion in abdomen. MR scan has been shown to be useful in demonstrating the fistulous tract extending to pancreas [7]. In our patient, MR scan showed of pancreatic pseudocyst with percutaneous pancreatic fistula.…”

La kystogastrostomie guidée par échoendoscopie dans le traitement des collections pancréatiques : expérience de l’hôpital militaire de Rabat (Maroc)

“…Les pseudokystes pancréatiques sont définis par des collections liquidiennes localisées de suc pancréatique, entourées d'une paroi fibreuse et non épithéliale [5]. Ils compliquent soit une pancréatite chronique dans 30 à 40 % des cas [6] et sont souvent de type rétentionnel, soit une pancréatite aiguë nécrosante.…”

Pancreatic pseudocyst-portal vein fistula

“…Pancreatic pseudocysts are well known as common complications of acute or chronic pancreatitis and complicate the course of chronic pancreatitis in 30% to 40% of patients [1][2][3]. However there have been few reports of pancreatic pseudocyst-portal vein fistulae that cause serious complications, including life-threatening sepsis.…”