Pancreatic pseudocyst overview
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Pancreatic pseudocyst Microchapters |
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Pancreatic pseudocyst overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vidhi Patel M.B.B.S.
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Overview
A pancreatic pseudocyst is a circumscribed collection of fluid rich in amylase and other pancreatic enzymes, blood and necrotic tissue typically located in the lesser sac. It has a non-epithelialised lining made of granulation tissue and hence the name pseudocyst (pseudo - false). By contrast, true cysts have an epithelial lining. This is typically a complication due to increased pressure in the pancreatic duct (e.g. stenosis, calculus, protein plugs) or pancreatic necrosis following an episode of acute pancreatitis, but may also occur following abdominal trauma. [1] Pancreatic pseudocyst generally complicates the course of chronic pancreatitis in around 30-40% of the patients.[2]
Historical Perspective
Classification
| TYPE | DESCRIPTION |
|---|---|
| I | <5cm, without symptoms, complication and neoplasia |
| II | Suspected cystic neoplasia |
| III | Location of Pancreatic Psuedocyst is Uncinate process
IIIa- Pseudocyst communicates with the pancreatic duct. IIIb- Pseudocyst does not communicate with pancreatic duct. |
| IV | Location of Pancreatic Pseudocyst is Head, Neck and Body.
IVa- Communication exist between pseudocyst and pancreatic duct (1) IVb- Distance from the cyst to the gastrointestinal wall is <1cm (2) IVc- Neither 1 nor 2 |
| V | Location of Pancreatic Pseudocyst is Tail.
Va- Splenic vein involvement or upper gastrointestinal bleeding Vb- Distance from the cyst to the gastrointestinal wall is <1cm without splenic vein involvement or upper gastrointestinal bleeding |
Pathophysiology
Pancreatic Pseudocyst, also known as "false cyst" as they do not have true epithelial lining. The pathophysiology of pancreatic pseudocyst involves trauma or episode of pancreatitis followed by extravasation of pancreatic secretions.
Causes
Differentiating Pancreatic pseudocyst overview from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Prevention
References
- ↑ Cooperman AM. An overview of pancreatic pseudocysts: the emperors new clothes revisited. Surg Clin North Am. Apr 2001;81(2):391-7, xii.
- ↑ Habashi S, Draganov PV (2009). "Pancreatic pseudocyst". World J Gastroenterol. 15 (1): 38–47. doi:10.3748/wjg.15.38. PMC 2653285. PMID 19115466.
- ↑ Pan G, Wan MH, Xie KL, Li W, Hu WM, Liu XB; et al. (2015). "Classification and Management of Pancreatic Pseudocysts". Medicine (Baltimore). 94 (24): e960. doi:10.1097/MD.0000000000000960. PMC 4616556. PMID 26091462.