A pancreatic cyst is a closed sac lined with epithelium and located on or within the pancreas. Pancreatic cysts contain a pool of pancreatic fluid or semisolid matter made up of debris or destroyed tissue.

They can range from benign pseudocysts (see below)

to malignant cysts (cancerous and spreading.) The cause of a particular pancreatic cyst is often unknown.

Pancreatic Pseudocyst:

Pancreatic Pseudocyst is the most common pancreatic cystic lesions (about 75% to 80% of all pancreatic cystic lesions), caused by acute or chronic pancreatitis, It is caused by blockage in the pancreatic ductal system. It is usually round or oval in shape and benign (non-cancerous).It is usually located behind the stomach (lesser sac) and may extend below the level of colon(infracolic) even to pelvis and scrotum . Superiorly it may extend to chest (Mediastinium)

Pseudocyst. usually resolve spontaneously by gradual absorption of the fluid, but sometimes, especially if there is a communication with the pancreatic duct, the cyst will persist and may

cause symptoms by pressure on other organs or by infection and causing septicemia. Such symptomatic Pseudocyst need treatment. This is usually done by removal of contents and internal drainage of cyst with bowel by surgery . The surgery involves connecting the wall of the cyst to either the wall of the stomach or an adjacent loop of bowel and forming a permanent join (anastomosis) that allows the fluid to drain into the stomach or intestine Sometimes endoscopic internal drainage by placement of stent ( tube) between cyst cavity and stomach is helpful.

Complications of pancreatic pseudocysts:

Many complications may develop from pancreatic cysts/pseudocysts, most common is infection, which can sometimes lead to abscess

Pseudocyst rupture (breaking open) or hemorrhage (bleeding), it 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( sclera) to appear yellow (obstructive jaundice)

Portal hypertension, which is high blood pressure of the splenic vein/portal vein, may require surgery.

Prof. Mohammad Ali