Pancreatic cysts are abnormal growths in the pancreas. Such growths appear in the form of blisters. A distinction is made between pseudocysts and real cysts. They can be removed without the need for surgery.
What is a pancreatic cyst?
The true cysts consist of epithelium. Epithelium is one of the four basic tissue types that is found in many different places in the body and is completely normal. Epithelium does not contain blood vessels or pancreatic enzymes such as lipase and amylase and consists of very small, densely packed cells. See gradinmath for What is Pulmonary Edema.
True cysts are less common than pseudocysts. There are three different forms of real cysts: The so-called congenital cysts are congenital, i.e. hereditary cysts. Retention cysts often occur in chronic pancreatitis and form from narrowing and bulging of ducts in the pancreas.
The third form, the so-called neoplastic cysts, consist of tumor tissue and can only be distinguished from pseudocysts by closer examination and tissue removal. They cannot be assessed using imaging methods such as sonography.
Causes
Pseudocysts resulting from injury to the pancreas or from acute pancreatitis are bordered by scar-like tissue. They contain pancreatic enzymes (lipase and amylase) that ensure that the pancreatic tissue can digest itself. Inside is serum or blood sometimes associated with dead tissue.
Pancreatic cysts can sometimes be hereditary.
True cysts are either congenital, result from chronic pancreatitis, or form from protuberances in the pancreas.
Symptoms, Ailments & Signs
A pancreatic cyst is initially manifested by non-specific symptoms such as tiredness, fever or gastrointestinal complaints. Those affected suffer more from nausea and vomiting or flatulence. Blood vomiting also often occurs. This is accompanied by severe pain in the abdomen, which can radiate to the back and abdomen.
Larger cysts cause abdominal pain, cramps and colic. If the cysts have formed metastases in the abdomen, this can be recognized by the palpable growths. In individual cases, a pancreatic cyst is completely symptom-free. The patient only notices the tumor at a late stage, when oppressive pain, abdominal cramps and external signs such as ascites appear.
An untreated pancreatic cyst can lead to sepsis. This manifests itself, among other things, in the form of a rising fever, severe pain and exhaustion. If the bile duct is squeezed, jaundice can result, which is characterized by fatigue and fever, and yellowing of the skin and conjunctiva of the eyes.
In addition, a malignant pancreatic carcinoma can develop from the cyst. Pancreatic cyst symptoms develop gradually, often over the course of weeks or months. By the time the patient notices the condition, the cyst is often far advanced.
Diagnosis & History
Signs of a pancreatic cyst can include non-specific symptoms such as general weakness, weakness of the heart, flatulence, fainting, chills, fever, vomiting and nausea, vomiting blood, pain in the back and clouding of consciousness.
In the case of larger cysts, it is not uncommon for abdominal pain to occur, which can even lead to colic. In some cases, pancreatic cysts develop into tumors that can also be felt in the abdomen. In many cases, however, there are no symptoms at all.
In most cases, pancreatic cysts can be detected using the imaging method of a sonography. Computed tomography, ERCP, or angiography is sometimes needed. In the event of an injury to the pancreas, abdominal flushing, a so-called lavage, can be used to determine lipase and amylase.
Complications
If there is a pancreatic cyst in the pancreas, this can sometimes lead to serious complications. The risk is considered to be particularly high if the pseudocyst is acute or has a pronounced size. One of the most common sequelae of pancreatic cysts are infections.
These often cause abscesses. These are encapsulated cavities that are filled with pus. There is also an increased risk of developing peritonitis. A side effect is the development of a so-called water belly, which is caused by a massive accumulation of fluid in the abdomen. In this case, doctors speak of ascites.
Furthermore, the infections can lead to life-threatening blood poisoning (sepsis). Bleeding is another common complication. In the worst case, the bleeding causes a drop in hemoglobin, which in turn has acute life-threatening effects. Obstructive cholestasis is also one of the consequences of pancreatic cysts.
If there is compression of the bile duct, a pancreatic pseudocyst located in the head of the pancreas sometimes causes jaundice (icterus). In addition, the gallbladder fills up. In medicine, a bulging gallbladder, which is accompanied by painless jaundice, is also considered a suspicion of a pancreatic tumor (pancreatic cancer). Another serious complication of the pancreatic cyst is the development of pancreatic carcinoma. The risk of pancreatic cysts becoming malignant increases with age.
When should you go to the doctor?
Recurring colic, swelling in the upper abdomen and pain indicate a pancreatic cyst. A doctor’s visit is advisable if the symptoms do not go away on their own within a week. If the symptoms get worse or other symptoms appear, it is best to call the doctor immediately. The same applies to serious complications such as fever or pain attacks. Then the family doctor should be called immediately. Bleeding, abscesses and signs of jaundice are also serious warning signs that need to be checked out by a doctor immediately. It is best for those affected to call the emergency services so that treatment can be initiated as quickly as possible.
Anyone who eats unhealthily or generally maintains an unhealthy lifestyle with an unbalanced diet and little physical exercise is particularly at risk of developing a pancreatic cyst. People with previous illnesses such as pancreatic cancer or necrosis in the area of the pancreas are also among the risk patients and should have the symptoms mentioned immediately examined by a doctor. A pancreatic cyst is treated by your family doctor or a gastroenterologist. During the treatment, nutritionists and physiotherapists canto be consulted. Follow-up care is provided by the gastroenterologist and later by the general practitioner. In the case of unusual symptoms, the responsible doctor must be informed. In the case of serious illnesses, treatment in a pancreas center is indicated.
Treatment & Therapy
If cysts develop as a result of pancreatitis, a detailed observation of the undesired growth is indicated first. In many cases, the cysts recede on their own and disappear after a while without causing any further symptoms.
If the patient complains of discomfort because of the cyst, drainage can be done. In this case, a hole is cut through the duodenum or stomach through which a gastroscope can be inserted. Such a hole is kept open by a stent, a special plastic tube, so that the fluid inside the cyst can gradually drain out.
It usually takes no more than three months for the cyst to empty, the outer walls of the cyst to stick together, and it to disappear. Only after this process can the plastic tube be removed again. In rarer cases where a cyst is filled with pus, it must be emptied using an endoscope.
This can also remove dead tissue that may be inside the cyst. Thanks to the procedure with the help of a stent or a gastroscope, it is not necessary to remove a cyst in an operation.
However, the treatment of pancreatic cysts can lead to complications such as unwanted bleeding or the formation of abscesses. A displacement of the duodenum is also possible, or jaundice, i.e. jaundice.
Complete restoration of the patient’s health after treatment of a pancreatic cyst is said to have a success rate of about 60 percent.
Outlook & Forecast
With the use of medical care, the prognosis for a pancreatic cyst is favorable. The cyst can be completely removed with surgery or other less risky techniques. Immediately after the wound has healed, the patient can be discharged from treatment as cured. The challenge is in diagnosing the disease. The cyst often goes unnoticed for a long time, as it usually causes no or only a few diffuse symptoms. However, once the diagnosis is established, the unwanted tissue should be removed.
Otherwise, with an unfavorable course of the disease, a life-threatening situation can develop. Bleeding in the area of the pancreas is possible, which can lead to complications and serious health changes. In addition, there is a risk that mutation of the tissue can take place. In these patients, the otherwise favorable prognosis is considerably worse. Rather, it can lead to a shortening of the expected lifespan. If medical care is therefore refused, the prospects of the person concerned change significantly. The earlier the diagnosis is made, the better the further course.
Despite having recovered and being free of symptoms, the cyst can form again at any time over the course of a person’s life. Even in these cases, the prognosis remains unchanged.
Prevention
There are no direct preventive measures against pancreatic cysts. Doctors only recommend a healthy lifestyle through a high-fiber diet and lots of sport and exercise.
Aftercare
If you have a pancreatic cyst, you should consult a doctor at an early stage to prevent other complications or worsening of the symptoms. The sooner a doctor is contacted, the better the further course of the disease, since self-healing with this disease cannot usually occur.
The measures and options for direct follow-up care for a pancreatic cyst are also relatively limited. The complaint itself can be alleviated relatively well with a minor surgical intervention. Usually there are no further complications or other complaints.
The affected person should take care of their stomach and intestines after such an operation and avoid greasy food. Only after some time can the food be adjusted again. As a rule, regular checks and examinations by an internist are still very important after the procedure in order to identify and treat further complaints at an early stage.
You can do that yourself
Patients with a pancreatic cyst are often very worried and excited. For a cyst measuring less than 2 cm, the patient’s best remedy is to remain calm. If the diagnosis was made as an incidental finding and there are no other symptoms related to the presence of the cyst, there is usually little cause for concern.
Stress, inner excitement and hustle and bustle are to be avoided. They reduce well-being and lead to psychological problems. It can be helpful to use various relaxation techniques to achieve inner balance. A cyst can mutate into a malignant tumor at any time. Nevertheless, the probability of a small pancreatic cyst is very low. Since there is a possibility that a small cyst will detach itself later on and be transported away by the organism, further observation should take place for the time being. Regular MRI checks and good self-awareness are important in these situations.
If the person affected notices changes or feels ill, they should initiate a check-up visit with a doctor. Comprehensive information about the disease is important so that the patient can make good and correct decisions for himself as the disease progresses. In addition, the organism should be strengthened and supported by a balanced diet and sufficient exercise.
