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Pancreatic Cysts

WHAT ARE PANCREATIC CYSTS?

Pancreatic cysts are sac-like collections of fluid within the pancreas. The majority of these cysts are benign and do not cause any symptoms. However, there are some cysts that can turn cancerous and should be monitored.

Pancreatic pseudocysts are different from true pancreatic cysts. Both are collections of fluid, but a true cyst has a lining while a pseudocyst has no lining.

At Loma Linda University Health, we treat more pancreatic disorders than any other center in the region. We have the ability to diagnose and treat pancreatic cysts  in addition to other underlying pancreatic conditions.

WHAT ARE THE SYMPTOMS OF PANCREATIC CYSTS?

Most people with pancreatic cysts experience no symptoms. When there are symptoms, they usually include:

  • Persistent abdominal pain, which may radiate to the back
  • Nausea and vomiting
  • A mass in the upper abdomen that can be felt

In some instances, pancreatic cysts can become infected. Symptoms of pancreatic cyst infection include fever and persistent abdominal pain. Pancreatic cyst patients who experience these symptoms should seek medical attention immediately.

Likewise, a ruptured pseudocyst can be a medical emergency requiring immediate attention. Symptoms of a ruptured pseudocyst include:

  • Fainting
  • Severe abdominal pain
  • Shock
  • Decreased consciousness
  • Weak and rapid heartbeat
  • Vomiting blood

WHAT CAUSES PANCREATIC CYSTS?

Although the cause of most pancreatic cysts is unknown, researchers believe pancreatitis may be one cause for developing these cysts. In addition, some pancreatic cysts are associated with rare illnesses.

In some cases, abdominal injuries appear to be a risk factor for pseudocysts.

HOW ARE PANCREATIC CYSTS DIAGNOSED?

A diagnosis of pancreatic cysts begins with a medical exam and health history of the patient, in addition to an assessment of any symptoms. Further diagnostic tests may include:

  • Endoscopic ultrasound (EUS), which may include collecting a sample of the cyst fluid
  • CT scan
  • MRI

HOW ARE PANCREATIC CYSTS TREATED?

At Loma Linda University Health, the most common methods for treating pancreatic cysts include:

Draining the cyst – A benign cyst (pseudocyst or serous cystadenoma) causing bothersome symptoms or increasing in size may be drained using an endoscopic procedure with fine needle aspiration (EUSFNA). A stent can also be placed via EUS to connect the cyst with the stomach to help decompress the cyst (cystogastrostomy).

Surgery – Surgery may be needed to remove some benign cysts. As is the case for any pancreatic surgery, this is a major undertaking. It is best to reserve resection for cases in which there is a significant concern for cancer. This represents a minority of cases. In the vast majority of cases, surveillance with periodic imaging tests is all that is needed.

Watchful waiting – A benign pseudocyst, even a large one, can be left alone as long as it isn't growing or bothering you. Discussion with your physician is needed to determine the best monitoring strategy for your benign cysts.

WHAT ARE THE COMPLICATIONS OF PANCREATIC CYSTS?

Although rare, complications can result from pancreatic cysts/pseudocysts. These include:

  • Infection, which can sometimes lead to a pancreatic abscess
  • Pseudocyst rupture (breaking open) or hemorrhage (bleeding), which can
  • be life-threatening
  • Biliary complications, causing jaundice (yellowing of the eyes and skin)
  • High blood pressure, known as portal hypertension

WHO IS AT RISK FOR PANCREATIC CYSTS?

Those most at risk for developing pancreatic cysts include:

  • Heavy alcohol users
  • People who suffer from gallstones
  • People who suffer from pancreatitis
  • Those who have had an abdominal injury

NEXT STEPS

  • Stay aware. If you are in the risk category for pancreatic cysts, stay aware of the symptoms of pancreatic cysts. Seek medical attention immediately if you begin experiencing any symptoms, and implement any lifestyle changes needed to reduce your risks. Alcohol use is one risk factor that can addressed through lifestyle change.
  • Seek medical intervention. If left untreated, pancreatic cysts can lead to more serious complications. To request an evaluation at Loma Linda University Health, contact your provider or schedule the appointment through MyChart.