Pancreatic pseudocyst

As a pancreatic cyst is called a morbid bubble-shaped formation ( cyst ) in the pancreas ( pancreatic ). They are divided into true cysts and pseudocysts.

Classification and Causes

Pancreatic cysts can be mechanical, inflammatory or neoplastic nature. When mistakes ontogeny cysts can also occur in the pancreas.

True cysts

Here are epithelium-lined cysts. The contents of the cyst does not contain the pancreatic enzymes such as lipase or amylase. Overall, the true cysts are rare. The true cysts can be divided as follows:

  • Congenital cysts: Congenital cysts may occasionally be associated with polycystic kidney and liver cyst.
  • Retention cysts: They are caused by the narrowing and subsequent distention of the pancreatic duct. The retention cysts often occur in the setting of chronic pancreatitis. The ductal epithelium -lined cysts are small, multiple and are related to the major pancreatic duct in contact.
  • Neoplastic cysts: These are mostly cystadenomas or cystadenocarcinomas. You can take the form of unilocular cyst, which by imaging techniques (eg ultrasound ) can not be distinguished from the pseudocysts. The walls of these cysts consist of Tumorepithel.

Pseudocysts of the pancreas

These common cysts are usually caused by an injury (trauma ) of the pancreas, acute pancreatitis or chronic relapsing pancreatitis. The limitation of these cysts is in contrast to the true cysts of scarred tissue. By the pancreatic enzymes, there is a self-digestion of the pancreatic tissue, wherein the compound can be maintained for the transition system. Pseudocysts contain either serous or bloody ( hemorrhagic ) fluid, necrotic tissue remnants may be present.

Symptoms

Depending on the size it can cause radiating in the back upper abdominal pain and colic. Possibly can be a tumor in the upper abdomen buttons. Frequently pancreatic cysts remain asymptomatic.

Diagnosis

Sonographic can be pancreatic cysts represent good, may have a CT scan, ERCP or angiography displayed. In pancreatic injury, a lavage of the abdominal cavity may be indicated in order to then determine the amylase and lipase.

Therapy

Cysts caused by pancreatitis, may regress spontaneously, they are therefore initially observed. Causes the cyst because of their size complaints, so can be a drain. With a duodenoscope or a combined endoscopic ultrasound gastroscope, a hole is cut in the stomach or intestinal wall to pancreatic cyst and then inserted a plastic tube (stent ) into this hole through the stomach or duodenum. This stent the cyst fluid can drain. After 3 months of the cysts are drained in most cases the cyst walls and glued together. The stent can now be removed. Pus is in the cyst, one expands the hole by means of an inflatable catheter until an endoscope can be inserted through the hole in the cyst. The endoscope can now pay off scab and necrotic material. With the endoscopic approach, surgical relief operations in general not necessary.

Complications

There may be bleeding, abscesses and ascites. Furthermore, the duodenum can be laid. In obstruction of the bile duct jaundice is possible.

Swell

  • M. Müller ISBN 3-929851-04-0 Surgery
  • Pschyrembel 257th edition
  • Riede / Shepherd ISBN 3-13-683303-9 Pathology ( ISBN formally wrong )
  • Disease in gastroenterology
  • Disease in visceral surgery
  • Pancreas
Connective tissue Serum (blood)
632029
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