A pancreatic pseudocyst may form after acute or chronic pancreatitis, with development of a defined wall formed of granulation and fibrous tissue surrounding a fluid rich in pancreatic digestive enzymes. A pseudocyst may resolve on its own, or it may progress and cause complications.
Complications:
(1) rupture or chronic leakage. with ascites or pleural effusion
(2) compression or obstruction of stomach or duodenum, with persistent nausea and vomiting
(3) compression or obstruction of biliary drainage, with jaundice
(4) infection with or without abscess
(5) pseudoaneurysm with hemorrhage
(6) pain
(7) pancreatoenteric fistula
(8) splenic vein thrombosis
Indications for considering drainage (percutaneous, endoscopic or surgical):
(1) large size (> 6 cm) with no signs of regression after 6 or more weeks
(2) progressive increase in size
(3) infection
(4) bleeding
(5) clinical deterioration
(6) severe pain
(7) bowel or biliary obstruction
(8) pancreatopleural fistula
(9) severe pancreatic ascites
