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Pancreatic cysts are fluid-filled reservoirs that form within this organ. Pancreatic cysts can be life-threatening as they can lead to peritonitis or damage the arteries. What are the causes and symptoms of pancreatic cysts? Is a pancreatic cyst cancer? What is the treatment like when a pancreatic cyst is present? When is surgery necessary?

Pancreatic cystsare fluid-filled reservoirs (closed cavities) that can be located in the head, body, or tail of the pancreas. In medical terminology, there are two types of cysts - real and pseudocysts (pseudocysts), which account for about 70 percent. all cystic lesions of the pancreas. Both true and pseudocysts can contain pancreatic tissue cells, pancreatic enzymes, or blood, but each is covered with a different type of tissue.Pancreatic pseudocystsare surrounded by connective tissue. In turn, the wallof true cystsis made of epithelium. The reasons for their formation are also different.

Pancreatic cysts - causes

Pseudocysts are most often a complication of acute pancreatitis or chronic pancreatitis. Another, less common cause of pseudocysts are abdominal injuries or post-operative changes in the abdominal cavity.

Pancreatic pseudocysts are non-cancerous cysts.

True pancreatic cysts may result from the dilatation of the pancreatic duct caused by the obstructed outflow of pancreatic juice from the pancreatic duct to the duodenum (e.g. due to a cancerous tumor in the pancreatic duct or pancreatic duct stones). The constriction of the pancreatic duct, e.g. in the course of pancreatitis, can also lead to the formation of true cysts.

The formation of true cysts may also occur in the course of parasitic diseases - echinococcosis or ascariasis. Then the parasites can be located not only in the digestive tract, but also in some organs, e.g. in the liver or pancreas, where they form cysts (cysts) that enable them to survive.

In addition, true pancreatic cysts may be malignant neoplasms, but pancreatic cystic neoplasms are very rare (they account for less than 10% of all types of pancreatic cancer)gland).

True cysts may be neoplastic.

Most cystic pancreatic tumors are asymptomatic and relatively small. They are usually detected accidentally (during an ultrasound scan of the abdominal cavity for various reasons) in elderly people - most often in women.

In addition, pancreatic cysts can be congenital, i.e. a consequence of developmental anomalies or genetic defects (e.g. cystic fibrosis, congenital multi-organ cystic disease).

Pancreatic cysts - symptoms

Small pancreatic cysts usually develop asymptomatically and are detected accidentally during an ultrasound examination of the abdominal cavity for some other reason.

The symptoms of larger pancreatic cysts are mainly digestive system ailments:

If these symptoms appear after a recent pancreatitis, you may suspect pancreatic cysts in this organ.

  • lack of appetite
  • nausea and vomiting
  • abdominal pain (most often located in the lower abdomen) which may radiate to the back
  • flatulence
  • diarrhea
  • progressive weight loss

If the cyst is located in the area of ​​the head of the pancreas, yellowing of the mucous membranes and skin integuments also appears.

Important

Pancreatic cysts - serious complications

If the cyst is not treated on time, the cyst may become infected. Then a fever and very severe epigastric pain appear. Additionally, the infected cyst may rupture and its contents may spill out into the abdomen, with the risk of peritonitis, which is a life-threatening condition.

In addition, a pancreatic cyst can damage large arteries that run around the pancreas, which may cause them to rupture, bleeding out and die.

Pancreatic cysts - diagnosis

If a pancreatic cyst is suspected, blood tests and imaging tests are performed, thanks to which it is possible to locate the cyst and determine its size. The basic examinations are ultrasonography (USG) and computed tomography (CT). Another, now often recommended, examination is endoscopic ultrasonography.

However, these tests are often insufficient to make a clear diagnosis. Therefore, in certain cases, additional tests are performed, such as, for example, contrast media ultrasound (CEUS), magnetic resonance imaging (MR) or magnetic resonance cholangiopancreatography (MRCP).

In some cases, your doctor may order a biopsyneedle during endoscopic ultrasound.

Pancreatic cysts - treatment

Treatment of pancreatic cysts depends on their origin, nature, size, location and symptoms reported by the patient.

In the case of small pancreatic cysts that are not cancerous, the doctor may only order them to be monitored by ultrasound. Often (about 25% of cases), the cyst will self-absorb within 4-6 weeks.

If the cyst is not absorbed within a month or is constantly growing, as well as in the case of larger lesions (usually more than 5-6 cm in diameter), drainage is used, i.e. draining the cyst content through drains until they are completely elimination. The procedure can be performed using a needle inserted into the pancreas under ultrasound guidance. Endoscopic drainage under endoscopic ultrasound (EUS) guidance can also be performed.

When drainage is impossible, ineffective or when the cysts are cancerous, surgical treatment is required - surgical drainage of the pancreatic cyst (internal or external) or (as a last resort) removal of the pancreas.

According to an expertAgnieszka Ślusarska, dietitian

Diet to gain weight after pancreatic cyst surgery

I have had a pancreatic cyst surgery, I lost 32 kg in a year. I am 178 cm tall a year ago, I weighed 82 kg, and now I weigh 51. I have a liver diet recommended, I would really like to gain weight. How do I do it and what should I eat?

MSc Eng. Agnieszka Ślusarska, dietitian: The diet should be an easily digestible diet with the limitation of simple sugars and fat. It should be rich in calories and adapted to the individual needs and digestive capabilities of the digestive tract. Unfortunately, not knowing your case, I can only provide general assumptions.

It is worth eating a few small meals (even about 8 a day). It is essential that the products are of high quality, organic fruit and vegetables are recommended, e.g. young kohlrabi, asparagus, beets, carrots, parsley, lettuce, tomatoes and cucumbers peeled, zucchini, eggplant, cauliflower, broccoli, spinach, young beans asparagus, bananas, citrus, apples, apricots and peaches, melons; low-sugar fruit preserves, jacket potatoes, mashed potatoes, boiled potato dumplings. Vegetable stock soups, broth cooked on lean meat, low-fat vegetable sauces. Light spelled bread, graham, crisp bread, cereals (spelled, oat, rye), small groats (millet, semolina, barley), rice, fine noodles, rusks, wheat flour, bran (wheat, oat), crispscorn. Also important are soft-boiled eggs, protein omelettes ( although not always well tolerated) and lean dairy products. If it is well tolerated, skimmed yoghurt, kefir, buttermilk, sour milk, low-fat and semi-skimmed curd and homogenized cheeses can be included in the diet. Note: in case of symptoms of intolerance, discontinue milk products. Cooked organic meat and fish. When it comes to fats, use cold olive oil, rapeseed oil, linseed oil, fresh butter in small amounts.

In turn, avoid frying, breading, saturated fats (lard, fatty meats, fatty dairy products, fatty broths and sauces, roux, bone broths, fatty meat, french fries, potato pancakes, fried potatoes), as well as all sweets and alcohol. It is also worth avoiding: some vegetables (beans, peas, currants, gooseberries, plums, cherries, avocados, raw onions and browned in fat, white, red, Italian cabbage, mainly in combination with onions, fat and fatty meat); unripe fruit and with peel, highly sweetened fruit preserves.

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Gastrology