Pancreatic Pseudocysts Flashcards
1
Q
What is a pseudocyst?
A
Localised fluid collection rich in pancreatic enzymes
Non-epithelialized wall containing fibrous/granulation tissue
2
Q
How do pseudocysts form?
A
Due to disruptions of pancreatic duct
- pancreatitis >10/7
- extravasation of enzymes
3
Q
How do pseudocysts present?
A
Deep, persistent abdo pain Abdo mass Anorexia Jaundice Sepsis Pleural effusion
4
Q
What investigations are appropriate in suspected pseudocyst?
A
Amylase/lipase (may or may not be elevated) LFTs (abnormal if biliary tree involved) Abdo CT (gold standard) MRI ERCP/endoscopic USS
5
Q
What is the natural history of pancreatic pseudocysts?
A
Most resolve w/o intervention
Outcomes worse if
->6cm
-pancreatic necrosis
6
Q
What are the potential complications of pancreatic pseudocysts?
A
Bleeding (erosion into vessel)
Infection
GI obstruction
Pseudocyst rupture
7
Q
What are the management options for pseudocysts?
A
Supportive care/monitoring Drainage indicated if -complications (bleeding/infection) -relief of sx -concern about malignancy (cytology & cystic fluids)
8
Q
How can pseudocysts be drained?
A
Percutaneous
Endoscopic (ERCP)
Laparoscopic
