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World Journal of Gastroenterology Jan 2009Pancreatic pseudocysts are complications of acute or chronic pancreatitis. Initial diagnosis is accomplished most often by cross-sectional imaging. Endoscopic ultrasound... (Review)
Review
Pancreatic pseudocysts are complications of acute or chronic pancreatitis. Initial diagnosis is accomplished most often by cross-sectional imaging. Endoscopic ultrasound with fine needle aspiration has become the preferred test to help distinguish pseudocyst from other cystic lesions of the pancreas. Most pseudocysts resolve spontaneously with supportive care. The size of the pseudocyst and the length of time the cyst has been present are poor predictors for the potential of pseudocyst resolution or complications, but in general, larger cysts are more likely to be symptomatic or cause complications. The main two indications for some type of invasive drainage procedure are persistent patient symptoms or the presence of complications (infection, gastric outlet or biliary obstruction, bleeding). Three different strategies for pancreatic pseudocysts drainage are available: endoscopic (transpapillary or transmural) drainage, percutaneous catheter drainage, or open surgery. To date, no prospective controlled studies have compared directly these approaches. As a result, the management varies based on local expertise, but in general, endoscopic drainage is becoming the preferred approach because it is less invasive than surgery, avoids the need for external drain, and has a high long-term success rate. A tailored therapeutic approach taking into consideration patient preferences and involving multidisciplinary team of therapeutic endoscopist, interventional radiologist and pancreatic surgeon should be considered in all cases.
Topics: Cholangiopancreatography, Endoscopic Retrograde; Cholangiopancreatography, Magnetic Resonance; Diagnosis, Differential; Drainage; Endosonography; Female; Humans; Magnetic Resonance Imaging; Male; Pancreatic Pseudocyst; Pancreatitis; Tomography, X-Ray Computed
PubMed: 19115466
DOI: 10.3748/wjg.15.38 -
The Gastroenterologist Mar 1996Pseudocyst formation is a well-known complication of pancreatitis. Pseudocysts of the pancreas are localized collections of fluid occurring within the pancreatic mass or... (Review)
Review
Pseudocyst formation is a well-known complication of pancreatitis. Pseudocysts of the pancreas are localized collections of fluid occurring within the pancreatic mass or the peripancreatic spaces often following acute pancreatitis or in a patient with chronic pancreatitis without any previous history of an acute episode. The pathogenesis depends on the etiology: in acute pancreatitis, enzyme-rich fluid and products of autodegradation accumulate; in chronic pancreatitis, the cyst results from an obstructed duct. The natural history of the diseases has become clearer with the advent of ultrasound and computed tomographic scanning. The incidence of pseudocysts is noted to be higher as a result of better diagnostic techniques. Pseudocysts must be suspected in patients who have persistent abdominal pain or consistently elevated levels of pancreatic enzymes. Nearly one third of pancreatic pseudocysts resolve spontaneously. Some, however, require intervention. Surgery was the only option available for many years. Recently, newer methods, such as percutaneous drainage and endoscopic cystenterostomy, have been used. Percutaneous drainage is inexpensive, has a low complication rate, and is done under local anesthesia. The recurrence rate is high with a one-time needle aspiration; this rate can be reduced to less than 10% by using an indwelling catheter. On the basis of a review of literature and our own experience, we believe that percutaneous continuous catheter drainage should be the first choice in the management of pseudocysts that require intervention. Experience with the endoscopic technique is increasing, and it may prove to be a viable alternative in skilled hands in the future.
Topics: Drainage; Humans; Incidence; Pancreatic Pseudocyst
PubMed: 8689144
DOI: No ID Found -
Advances in Internal Medicine 1984
Review
Topics: Abscess; Adult; Aged; Ascites; Cholangiopancreatography, Endoscopic Retrograde; Diagnosis, Differential; Drainage; Female; Hemorrhage; Humans; Middle Aged; Pancreatic Cyst; Pancreatic Pseudocyst; Pancreatitis; Pleural Effusion; Prognosis; Rupture, Spontaneous; Tomography, X-Ray Computed; Ultrasonics
PubMed: 6369928
DOI: No ID Found -
The American Journal of the Medical... Jul 2023
Topics: Humans; Pancreatic Pseudocyst; Drainage; Tomography, X-Ray Computed
PubMed: 36791910
DOI: 10.1016/j.amjms.2023.02.005 -
Digestive and Liver Disease : Official... Feb 2022
Topics: Chronic Disease; Humans; Male; Medical Illustration; Middle Aged; Pancreatic Pseudocyst; Pancreatitis
PubMed: 33144055
DOI: 10.1016/j.dld.2020.10.017 -
The American Journal of Emergency... May 2021Pancreatic pseudocysts are seen both in acute and chronic pancreatitis. Prevalence of pancreatic pseudocyst in chronic pancreatitis is 20% to 40% and is most commonly...
Pancreatic pseudocysts are seen both in acute and chronic pancreatitis. Prevalence of pancreatic pseudocyst in chronic pancreatitis is 20% to 40% and is most commonly seen in alcoholic chronic pancreatitis. Intracystic hemorrhage from a pseudoaneurysm is a rare and potentially a lethal complication of pancreatic pseudocyst with an incidence of less than 10%. We herein present a case of a 42-year-old male with a past medical history of chronic alcoholic pancreatitis, stable pseudocyst in the tail of pancreas, alcohol abuse and seizures who presented with abdominal pain and acute anemia had this rare complication of hemorrhagic pseudocyst. The diagnostic modalities used to diagnose hemorrhagic pseudocyst are ultrasound with color doppler, CT with contrast, digital subtraction angiography and angiography. Angiographic embolization of the culprit artery is the preferred treatment of choice in the treatment of pseudoaneurysms. It is important for early recognition and treatment of this complication as the mortality can be as high as 40%.
Topics: Adult; Aneurysm, False; Humans; Male; Pancreatic Pseudocyst; Pancreatitis, Chronic; Splenic Artery; Tomography, X-Ray Computed
PubMed: 32197717
DOI: 10.1016/j.ajem.2020.03.020 -
ANZ Journal of Surgery Oct 2021
Topics: Diagnostic Errors; Drainage; Humans; Pancreatic Pseudocyst; Pancreatitis
PubMed: 33634581
DOI: 10.1111/ans.16700 -
Digestive Surgery 2003
Review
Topics: Chronic Disease; Diagnosis, Differential; Drainage; Endoscopy; Humans; Pancreatic Pseudocyst; Pancreatitis
PubMed: 12900529
DOI: 10.1159/000072706 -
Annals of the Royal College of Surgeons... Jan 1994This debate reviews the arguments in favour of surgical or non-surgical techniques for the management of pancreatic pseudocysts. Surgery provides definitive management... (Review)
Review
This debate reviews the arguments in favour of surgical or non-surgical techniques for the management of pancreatic pseudocysts. Surgery provides definitive management and has a low risk of recurrence; pancreatic resection may be required to achieve this. Surgical treatment of pancreatic pseudocyst is safe, with little morbidity and low mortality, and surgical drainage allows biopsy of the cyst wall to exclude a cystic neoplasm of the pancreas. Percutaneous techniques have the advantage of low morbidity and mortality, with less discomfort to the patient than a surgical incision. In selected patients, a good result can be anticipated. The balance of the evidence suggests that both approaches are useful in different patients. Pseudocyst management should be tailored to each individual case.
Topics: Acute Disease; Drainage; Humans; Pancreas; Pancreatic Pseudocyst; Pancreatitis; Postoperative Complications
PubMed: 8117022
DOI: No ID Found -
Journal of Clinical Gastroenterology Jan 2000Pancreatic pseudocyst in the liver is a rare complication of acute or chronic pancreatitis. However, its frequency seems to be increasing with modem imaging procedures.... (Review)
Review
Pancreatic pseudocyst in the liver is a rare complication of acute or chronic pancreatitis. However, its frequency seems to be increasing with modem imaging procedures. The authors report a case of pancreatic pseudocyst involving the left lobe of the liver that occurred in a patient who never showed clinical evidence of pancreatitis or pancreatic injury. Complete screening led to the discovery of alcoholic chronic pancreatitis. The pseudocyst was treated successfully by radiologic drainage. The pancreatic pseudocyst location and therapeutic approaches are discussed. A literature review uncovered 26 cases of hepatic pancreatic pseudocysts. Clinical presentation, imaging characteristics, and treatment of these cases are analyzed.
Topics: Drainage; Humans; Liver Diseases; Male; Middle Aged; Pancreatic Pseudocyst; Pancreatitis, Alcoholic; Tomography, X-Ray Computed
PubMed: 10636217
DOI: 10.1097/00004836-200001000-00016