Pancreatic Pseudocyst

What is a pancreatic pseudocyst?

A pancreatic pseudocyst (pronounced PAN-kree-AT-ik SOOD-oh-sist) is a fluid-filled sac that forms in your belly. It may also contain pancreatic tissue, digestive juices (enzymes), and blood.

This can create a painful mass in your pancreas.

The pancreas is located behind your stomach on the left side of your belly. It is close to the first part of the small intestine (the duodenum).

The pancreas is a gland with 2 main jobs:

  • It sends out digestive juices to your small intestine. These juices help break down food.
  • It makes hormones that control your blood sugar levels. It sends the hormones into your blood.

When the pancreas is hurt, the tubes or ducts that send out digestive juices can get blocked. This causes a pancreatic pseudocyst.

What causes a pancreatic pseudocyst?

Pancreatic pseudocysts most often happen in people with pancreatitis. This is a painful redness and swelling (inflammation) of the pancreas.

People with long-term (chronic) pancreatitis due to alcoholism are at greatest risk for pancreatic pseudocysts.

Other less common causes include pancreatitis due to:

  • Gallbladder disease
  • Surgery
  • Injury
  • Medicines and toxins
  • Problems present since birth (congenital)

What are the symptoms of a pancreatic pseudocyst?

Each person’s symptoms may vary. Symptoms may include:

  • Belly pain
  • Nausea and vomiting
  • Not feeling hungry
  • Weight loss
  • Diarrhea
  • Fever
  • Lump or mass in your belly
  • Tender, swollen belly
  • Yellowish skin and eyes (jaundice)
  • Fluid buildup in your belly

In some cases, pseudocysts have no symptoms.

Symptoms may look like other health problems. Always see your healthcare provider to be sure.

How are pancreatic pseudocysts diagnosed?

Your healthcare provider will look at your past health. He or she will give you a physical exam.

You may also have tests including:

  • Blood tests. These are done to look for acute pancreatitis.
  • Belly or abdominal X-ray. This test makes images of internal tissues, bones, and organs.
  • CT scan (computed tomography scan). This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.
  • Ultrasound (also called sonography). This makes images of blood vessels, tissues, and organs on a computer screen. It uses high-frequency sound waves. It is used to view internal organs in your belly. It also checks blood flow through different vessels.
  • EUS. This is an internal ultrasound done through a lighted tube passed into the mouth.
  • ERCP (endoscopic retrograde cholangiopancreatography). This can find and treat problems in your liver, gallbladder, bile ducts, and pancreas. It uses X-ray and a long, flexible tube (an endoscope). The tube has a light and camera at one end. The tube is put into your mouth and throat. It goes down your food pipe (esophagus) and stomach, and into the first part of your small intestine (the duodenum). A dye is put into your bile ducts through the tube. The dye lets the bile ducts be seen clearly on X-rays.
  • MRCP (magnetic resonance cholangiopancreatography). This test uses a magnetic field and radiofrequency waves to see the pancreas and surrounding region.

How are pancreatic pseudocysts treated?

Your pseudocyst will be checked to see if it is growing. Pseudocysts that don’t get bigger and don’t cause symptoms often go away.

Your pseudocyst will be treated if it gets bigger or if there is a risk of other health problems.

If you have acute pancreatitis, you will likely be in the hospital for a few days. You will be given IV (intravenous) fluids and pain medicine, and watched closely. You won’t be allowed to eat or drink for a few days. This is so your pancreas can rest.

Treatment may include:

  • Close monitoring using scans. This is done to see if your pseudocyst is growing.
  • Endoscopic drainage of the cyst. This removes fluid or infection from the pseudocyst. It uses both X-rays and a long, flexible lighted tube (endoscope). The tube is put into your mouth and throat. It goes through your food pipe (esophagus), stomach, and duodenum into your pancreas. The inside of these organs can be seen on a video screen. The screen is connected to a tiny camera in the tube. Tools on the tube can drain the fluid.
  • External drainage. This may be done if your pseudocyst is infected. A tube called a catheter is put through your skin to drain the cyst. It is drained using a needle that’s guided by a CT scan.
  • Surgery to drain the cyst. If your pseudocyst keeps growing and causes pain, you may need surgery to drain it. The surgeon makes a connection between the cyst and a nearby organ such as the stomach or small intestine. The pseudocyst is drained through that organ.

What are the complications of pancreatic pseudocysts?

If a pseudocyst is not watched or treated, it can cause problems including:

  • Dangerous blood loss (hemorrhage) if the pseudocyst harms nearby blood vessels
  • Burst or ruptured pseudocyst
  • Infection
  • Blocked intestines or bile duct

Key points about pancreatic pseudocysts

  • It is a fluid-filled sac that forms in your belly. It may also contain pancreatic tissue, digestive juices (enzymes), and blood.
  • It can happen when the pancreatic tubes (ducts) that send out digestive juices get blocked.
  • It most often happens in people who have pancreatitis. This is a painful redness and swelling (inflammation) of the pancreas.
  • If it doesn’t get bigger and or cause symptoms, it will often go away.
  • It may need to be drained. If it keeps growing and causes pain, you may need surgery.


Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.