Pancreatic Pseudocysts

Posted by e-Medical PPT
Localized collection pancreatic secretions
Within or adjacent to pancreas
Enclosed by a nonepithelialized wall
Associated w/ pancreatic duct disruption

Etiology
Acute Pancreatitis
More associated w/ alcohol related pancreatitis
Chronic pancreatitis
Pancreatic trauma
Pancreatic neoplasm

Pathogenesis
Acute Pancreatitis
Pancreatic necrosis causes ductular disruption, resulting in leakage of pancreatic juice from inflamed area of gland, accumulates in space adjacent to pancreas
Inflammatory response induces formation of distinct cyst wall composed of granulation tissue, organizes w/ connective tissue and fibrosis

Chronic Pancreatitis   
Pancreatic duct chronically obstructed  ongoing proximal pancreatic secretion leads to saccular dilation of duct – true retention cyst
Formed microcysts can eventually coalesce and lose epithelial lining as enlarge

Symptoms and Signs
Insidious midepigastrium pain, radiation to back
Pain aggravated by food
n/v, abdominal fullness
Small to moderate cysts can be assymptomatic
Palpable mass in epigstrium if large
Jaundice only in 10%
Also may have pleural effusion, chylous ascites, portal hypertension..

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