In this study, the authors explored the cytomorphologic features of pseudocyst of the pancreas and evaluated the role of alcian blue and mucicarmine stains in the cytologic evaluation of. Acute pseudocysts arise as a sequela of acute pancreatitis, require at least 4 weeks to form, and are devoid of significant solid debris. We present a case of 21yearold male, admitted to our department, who was a known case of posttraumatic acute pancreatitis and who developed massive upper gi bleeding. Pseudocyst due to a non pancreatic cause, however, is very rare. Research article efficacy, safety, and longterm followup. Download the ebook pancreatic cancer in pdf or epub format and read it directly on your mobile phone, computer or any device. Spontaneous rupture of a pancreatic pseudocyst bmj case. Other complications such as pseudocyst formation, pseudoaneurysm formation, or venous thrombosis, increase morbidity and mortality to a lesser degree. Cystoduodenostomy was performed when the cyst was located in the head and uncinate of the pancreas. Pancreatic pseudocyst are localised fluid collections as a result of acute or chronic pancreatitis. A pancreatic pseudocyst is a circumscribed collection of fluid rich in pancreatic enzymes, blood, and necrotic tissue, typically located in the lesser sac of the abdomen. Drainage was the treatment of choice for a mature pseudocyst. While pleural effusion is a common complication of pancreatitis, transthoracic extension of a pseudocyst is a rare phenomenon.
Heavy alcohol use and gallstones are risk factors for pancreatitis, and pancreatitis is a risk factor for pseudocysts. Roentgenographic series of the upper part of the gastrointestinal tract failed to demonstrate pancreatic pseudocyst in 7. Pancreatic pseudocysts are collections of leaked pancreatic fluids. Classification and management of pancreatic pseudocysts. Ct angiography of abdomen showed aneurysm of gastroduodenal artery. There was one successful palliation of a postoperativeinfected pseudocyst in a patient with an obstructing nonresectable carcinoma of the head of the pancreas. Fischer, mastery of surgery, 6 th edition cameron, current surgical therapy 10 th edition blumgarts surgery of the liver and biliary tract. We report a 49yearold male, who presented to the emergency department with moderate intensity lower abdominal pain. Today, the most used definitions differentiate between peripancreatic fluid collections, pseudocysts and pancreatic abscesses as in the atlanta classification system for acute pancreatitis. Often pseudocysts get better and go away on their own. Pancreatic pseudocysts are the most common pancreatic cystic lesions about 75% to 80% of all pancreatic cystic lesions and affect approximately 1 in 1,000 adults per year.
Acute pancreatitis affects about 50,000 80,000 americans each year. Painful, localized collections of pancreatic secretions that develop after pancreatitis acute or chronic, trauma, ductal calculi, obstructive neoplasms complications. Robert zollinger, md overview the pancreatic pseudocyst is a collection of pancreatic secretions contained within a fibrous sac comprised of chronic inflammatory. Pancreatic pseudocysts are common sequelae of acute pancreatitis or chronic pancreatitis, and the most common cystic lesion of the pancreas. A 68yearold male with the remote history of alcohol abuse presented with abdominal pain secondary to acute pancreatitis. Pseudocyst of the pancreas extending into the thorax represents a rare but potentially catastrophic diagnosis. Pancreatic pseudocyst pathology video online learning. Hemorrhage into pseudocyst of pancreas can rarely present as life threatening massive ugi bleeding. Signs are similar to those of pancreatitis and include poor appetite, lethargy, vomiting, or abdominal pain.
In this study, cases a er acute pancreatitis type had walled o necrosis. Pancreatic pseudocysts are usually complications of pancreatitis, although in children they frequently occur following abdominal trauma. The first computed tomography ct of the abdomen showed acute necrotizing pancreatitis. A pancreatic pseudocyst is a collection of tissue and fluids that forms on your pancreas. The pancreas is an organ of the digestive system and endocrine system of vertebrates. Pseudocysts may form in a number of places, including the pancreas, abdomen, adrenal gland, and eye. Disorders of the pancreas in cats cat owners merck. Laboratory examinations showed normal blood counts. This topic will discuss the overall approach to management of pancreatic pseudocysts and walledoff pancreatic necrosis wopn.
Indications of eusgtd at our center are as follows. The pancreas and anesthesia pancreas pancreatic cancer. Primary and overall success rates for clinical outcomes after laparoscopic, endoscopic and open pancreatic. Pancreatic pseudocysts belong to a large and heterogeneous group of cystic pancreatic lesions and represent a complication of acute or chronic pancreatitis.
It can be difficult to both diagnose and manage, with only limited management suggestions within the literature. Fourth, oxidative stress due to free radicals in acinar cells results in. Percutaneous drainage of infected pancreatic pseudocysts. It makes fluids that flow through a duct into the small intestine. Abstractpancreatic pseudocysts are the most common cystic lesions of the pancreas and may complicate. Hemorrhagic pseudocyst of pancreas treated with coil.
Treatment of pancreatic pseudocysts, pancreatic necrosis. These structures are surrounded by fibrous and granulation tissue and contain fluid rich in amylase and other pancreatic enzymes. A pseudocyst is a cystic lesion that may appear as a cyst on scans, but lacks epithelial or endothelial cells. Pancreatic pseudocysts are a wellknown complication of acute or chronic pancreatitis, with a higher incidence in the latter. The management of pancreatic pseudocyst katherine a. Cureus one of the largest pancreatic pseudocysts in the. The cyst is usually filled with pancreatic juice rich in enzymes but can contain enzyme free serous fluid if there is no communication with the pancreatic ducts. Pseudocyst of the pancreas masquerading as spontaneous.
Isolated hydatid cyst of the pancreas masquerading as. If a pseudocyst is small and not causing serious symptoms, a doctor may want to. The incidence of pancreatic pseudocyst formation after posttraumatic pancreatitis ranges from 0% to 69%. If a pseudocyst is small and not causing serious symptoms, a doctor may want to monitor it with periodic ct.
Although a leaking pancreatic pseudocyst was the cause of ascites in at least 21 episodes 70%, an abdominal mass could only be palpated in two of 26 patients. Free uid was present in abdomen and bowel sounds were sluggish. Case summary 42 yr old male presented with complaints of abdominal pain for 20 days more over epigastric to left hypochondrium ho vomiting no ho abdominal distension,fever,hematemesis,melena,trauma, constipation no ho urinary symptoms no ho loss of. The pseudocysts appear to arise from an insult to the pancreatic. This includes external drainage, internal drainage, and excision. The pancreatic pseudocyst is a pancreatic fluid collection which classically develops due to acute or chronic pancreatitis.
Almost entirely fat free, this version of french toast can be adapted to almost any kind. Pancreatic pseudocyst most common cystic lesions of the pancreas, accounting for 7580% of such masses location lesser peritoneal sac in proximity to the pancreas large pseudocysts can extend into the paracolic gutters, pelvis, mediastinum, neck or scrotum may be loculated 4. Acute pancreatitis is one of the more commonly encountered etiologies in the. Pancreatic cancer an overview of diagnosis and treatment. In the exocrine pancreas, the relationship between structure and function, as well as between normal and pathological. Karunakar reddy department of general surgery, kakatiya medical college, warangal, telangana state. A free online edition of this book is available at. This article is from chinese journal of cancer, volume 33. Adams, md, facs the fascination that pseudocysts hold for surgeons is beyond comprehension. An acute pancreatic pseudocyst is made of pancreatic fluids with a wall of fibrous tissue or granulation.
It is a complication of inflammation of the pancreas pancreatitis. The new england journal of medicine 1972 n engl j med 375. Idiopathic retroperitoneal nonpancreatic pseudocyst in an. Case report hemorrhagic pseudocyst of pancreas treated. A study of clinical features and management of pseudocyst. Pancreatic pseudocysts can be treated with or without surgery. Hepatobiliary and pancreatic surgery pdf hepatobiliary and pancreatic surgery pdf free download, hepatobiliary and pancreatic surgery pdf, hepatobiliary and pancreatic surgery ebook content hepatobiliary and pancreatic surgery is part of the master techniques in surgery series, which presents common and advanced procedures in the major subspecialties of general surgery. The free trypsin then cleaves the rest of the trypsinogen, as well as chymotrypsinogen to its active form chymotrypsin. A trial of percutaneous catheter drainage is indicated in patients with infected pancreatic pseudocysts. The classification of pancreatic cysts, the endoscopic and surgical techniques used to manage pancreatic fluid collections, and the efficacy and complications of these techniques are discussed separately. Alternatively, areas of pancreatic and peripancreatic fat necrosis may completely liquefy over time.
It is a condition that arises suddenly and may be quite severe, although patients usually have a. A study of clinical features and management of pseudocyst of pancreas dr. The pseudocyst is characterized by the absence of epithelial lining in the cyst wall. A pancreatic pseudocyst is a collection of sterile pancreatic fluid enclosed by a wall of tissue.
They may form next to the pancreas during pancreatitis. They are important both in terms of management and differentiation from other cystic processes or masses in this region. Retroperitoneal pseudocyst rpc is an uncommon surgical entity. Currently several classification systems are in use that are based on the origin of the pseudocyst, their relation to pancreatic duct anatomy and a possible pseudocyst. The mechanism of formation of an acute pancreatic pseudocyst is usually as a result of limited pancreatic necrosis that produces a pancreatic ductal leak. Pancreatic pseudocysts account for approximately 75% of all pancreatic masses. Pseudo pancreatic cyst is a common complication of pancreatitis. The objective of this observational study was to study the different etiologies, clinical features, investigations and management of pseudocyst of pancrease in patients being treated at kmc hospital manipal.
It can be caused by injury or trauma to the pancreas but the most common cause of pancreatic pseudocysts. Pancreatitis is an uncommon disease characterized by inflammation of the pancreas. Pancreas pseudocyst an overview sciencedirect topics. The pancreas is an organ that sits behind your stomach.
1509 1649 302 1503 1367 811 845 244 170 17 1269 506 402 735 1446 1193 1382 940 380 446 253 418 627 497 341 674 1349 1043 1420 601 1055 246 528 1095 1261 1126 1389 213 1332 1359 456 1014 1168 314 349 565 271 1243