Pancreatic cysts can be best described as closed sacs that are located in or on the pancreas, lined with epithelium. Typically, these sacs will contain fluid. Some of these growths can be harmless or benign pancreatic pseudocysts, while others may be malignant cysts. The latter are cancerous and can lead to pancreatic cancer and even spread to the rest of the organs if not detected and treated in time.
There are different types of pancreatic cysts, some of them resulting from various conditions. Some of them develop due to rare diseases (like the genetic disorder called von Hippel-Lindau disease), while others occur for different reasons.
In this article, Dr. Omar Rashid and his expert team discuss the different types of pancreatic cysts and the most common symptoms and will also talk about treatment and management options.
Types of Pancreatic Cysts
There are several different types and subtypes of pancreatic cysts. To avoid confusion, medical experts usually divide these growths into two groups, more specifically, neoplastic and nonneoplastic cysts. As said above, both group has several subtypes, like serous cystadenomas, pseudocysts, mucinous cystitis neoplasms, and so on. Most of these growths are harmless without any apparent symptoms, but some may be malignant cysts.
About Pancreatic Pseudocysts
Pancreatic pseudocysts are those growths that develop on the pancreas but aren’t contained inside its own enclosed sac with an epithelium lining. Instead, these cysts form in the spaces or cavities inside the pancreas and are surrounded by fibrous pancreatic tissue.
These pancreatic pseudocysts usually contain the digestive enzyme amylase and other inflammatory pancreatic fluid; in some cases, they may also have semisolid matter.
Here’s what patients should know about pancreatic pseudocysts:
- They are most often caused by medical issues such as chronic pancreatitis.
- They may also form due to blockage in the ductal system of the pancreas.
- Regarding shape, they resemble the oval shape of an avocado.
- They are the most prevalent type of pancreatic cysts and lesions in the pancreas, making up around 75% to 80% of all pancreatic lesions.
- Pseudocysts aren’t malignant cysts, meaning they aren’t cancerous.
- They affect around one in every thousand adults each year.
About the Pancreas
The organ is a six-inch gland that can be found below the liver, specifically between the spine and the stomach. The organ has three distinctive parts: the head, which is in the upper part of the small intestine (the duodenum), the body, and the tail. The latter is connected to the human spleen.
The pancreas is responsible for producing potent hormones for better blood sugar management and digestive enzymes. Typically, these hormones and enzymes aren’t active until they leave the pancreas and enter other body parts.
The human pancreas is also responsible for bicarbonate production, for neutralizing stomach acids. These bicarbonates travel to the duodenum through a large pancreatic duct. The duct bile also goes through the pancreas, carrying bile from the gall bladder and the liver into the small intestine to break down fats.
Pancreatitis
Pancreatitis describes the condition when the organ becomes inflamed. This can manifest as an acute issue, which is a sharp, sudden, and often severe attack, or it can also be a long-lasting or recurring chronic issue.
When the organ becomes inflamed, the before-mentioned digestive enzymes become active inside the pancreas, leading to the pancreas literally digesting or eating its own tissue.
The most common reasons behind the development of pancreatitis are chronic alcohol abuse and gallstones. The latter are hardened pebble-like bile masses. On the other hand, the condition may develop due to injury or as a result of other diseases.
Lastly, pancreatic pseudocysts will often develop as severe pancreatitis complications.
Pancreatic Cyst Symptoms and Causes
Both cysts and pseudocysts can develop and exist in the organ without any obvious symptoms. On the other hand, pancreatic cyst symptoms may also produce moderate or severe problems.
Usually, symptoms will develop within only days or months after the pancreatitis attack, and they will usually be the following:
- Nausea
- Vomiting
- Abdominal bloating
- Persistent and severe abdominal pain that may radiate to the back as well
Pancreatic Cyst Complications
In rare cases, these growths are able to cause complications, such as the following:
- Cyst rupture or bleeding, which can, unfortunately, occur without any warning signs and can be life-threatening
- Infection, leading to pancreatic abscess
- A large cyst may block the bile duct leading to obstructive jaundice or the yellowing of the mucous membranes, the whites of the eyes, and the skin
- High blood pressure or portal hypertension
- The portal vein or splenic vein, which requires surgery
Diagnosing Pancreatic Cysts
Unfortunately, these pancreatic masses can be difficult to diagnose, mostly because the associated pancreatic cyst symptoms are similar to the signs of several other diseases. Also, because the pancreas is located deep in the cavity of the abdomen, experts must often use cross-sectional imaging to establish the presence of these cysts.
Diagnostic testing may include the following:
- Computed tomography, or CT scans, can provide the necessary diagnostic info and enable the experts to observe the pathology and anatomy of the cysts and the pancreas.
- Magnetic resonance imaging (MRI) or magnetic resonance cholangiopancreatography (MRCP). They are rarely used but provide better images of the fluids and debris in pseudocysts than traditional CT scans.
- Ultrasound tests, more specifically transabdominal US. These tests use the help of soundwaves to discover both cysts and gallstones that can potentially cause problems.
- Endoscopic ultrasound, or EUS, is a secondary test performed after the above-mentioned three scans to evaluate the growths further. Experts obtain fluid from the cyst through a fine needle to differentiate the different types of pancreatic cysts.
- ERCP or endoscopic retrograde cholangiopancreatography so the expert can view the structure of the different ducts within the pancreas.
Pancreatic Cyst Treatment
For the most part, pancreatic cysts can resolve on their own without any medical interventions over time. Still, in cases when the symptoms are persistent, and the cysts are causing problems and complications or start to grow, pancreatic cyst treatment will usually involve draining the growth.
Typically, experts drain the cysts using one of the following three drainage methods:
- Percutaneous catheter drainage using a hollow tube that’s inserted into the body with the purpose of fluid removal
- Endoscopic drainage, which is becoming more and more popular as it’s less invasive, has fewer complications and shows better overall long-term success rates
- Surgical drainage, where experts use open or laparoscopic surgery to drain the cysts
The Discomfort Shouldn’t Last
While most of these pancreatic growths will be able to go away on their own, some of them will need to be removed, mainly if they are producing severe symptoms or if there’s a concern that the cysts are malignant or in a precancerous state.
Still, the prognosis is good for patients undergoing pancreatic cysts treatment. As such, if you’d like to learn more about the procedure or the nature of these pancreatic masses, schedule an appointment with our experts today.