Pancreatic Cysts

Fluid-filled pockets, called cysts, can sometimes form on or inside the pancreas. The pancreas is a part of your digestive system, located behind your stomach. It makes important substances (hormones and enzymes) that help your body break down food. Often, these pancreatic cysts are discovered accidentally during medical tests done for something else.

Pancreatic cysts are often discovered during routine abdominal imaging, even if you don't have any noticeable symptoms. This means the cyst is found as a side effect of another medical test.

Sometimes, pancreatic cysts do cause symptoms. If you have a cyst that's causing problems, you might experience:

• Consistent stomach pain: This pain can sometimes spread to your back.
• Feeling sick to your stomach (nausea) and throwing up (vomiting): These are common symptoms of various digestive issues.
• Losing weight without trying: Unintentional weight loss can be a sign of many health problems, including some affecting the digestive system.
• Feeling full quickly after eating: This is a common symptom that can indicate a number of different problems, including possible blockages or pressure in the digestive tract.

These symptoms can vary in intensity. If you experience any of these, it's important to talk to your doctor.

Sometimes, a cyst can get infected. If you have a fever and ongoing stomach pain, see a doctor right away.

Pancreatic cysts, while uncommon, can sometimes break open (rupture). This is a serious medical problem. When a cyst ruptures, it can lead to an infection in the lining of your abdomen called peritonitis.

Many pancreatic cysts have no known cause. Sometimes, cysts are linked to rare medical conditions like polycystic kidney disease or von Hippel-Lindau disease. This latter condition can affect not only the pancreas but other parts of the body as well. It's passed down through families.

Other cysts, called pseudocysts, often develop after a person has a painful episode of pancreatitis. Pancreatitis happens when digestive enzymes in the pancreas become active too soon, irritating the organ. This can be very unpleasant and lead to a pseudocyst. Pseudocysts can also form if the abdomen is injured, perhaps from an accident like a car crash.

Drinking too much alcohol and having gallstones can increase your chances of getting pancreatitis. Pancreatitis, in turn, can make you more likely to develop a pseudocyst. Also, injuries to your abdomen can lead to pseudocysts.

Pseudocysts are pockets of fluid that can form in the pancreas. The best way to prevent these pseudocysts is to avoid getting pancreatitis. Pancreatitis is often linked to two main causes: gallstones or drinking too much alcohol.

If gallstones are the problem, your doctor might recommend removing your gallbladder. This surgery can help prevent pancreatitis and, therefore, pseudocysts.

If alcohol use is the cause of pancreatitis, cutting back on or stopping alcohol consumption will significantly reduce the risk of developing this problem and, consequently, pseudocysts.

Doctors are now finding more pancreatic cysts than in the past, thanks to better ways to see inside the body. These cysts are often discovered during routine scans for other health issues.

To figure out what's going on, your doctor will first ask about your medical history and do a physical exam. They might then recommend some imaging tests to help diagnose the cyst and plan the best treatment. These tests include:

Understanding the Tests:

• CT scan (Computed Tomography): This test creates detailed pictures of the cyst's size and structure.
• MRI scan (Magnetic Resonance Imaging): This test can show small details in the cyst, helping to see if it might be more likely to be cancerous.
• Endoscopic Ultrasound: This test uses a thin, flexible tube with a camera on the end to get a close-up view of the cyst. It can also collect fluid from the cyst for lab tests to check for cancer markers.
• MRCP (Magnetic Resonance Cholangiopancreatography): This is often the best test for checking cysts in the pancreatic duct, which is a tube in the pancreas.

Different Types of Pancreatic Cysts:

It's important to know that many types of pancreatic cysts exist, some are harmless (benign), while others can be cancerous. The type of cyst can sometimes be guessed based on its location, size, and your age and sex. Here are a few examples:

• Pseudocysts: These are usually harmless (benign) and often result from inflammation of the pancreas (pancreatitis) or injury.

• Serous Cystadenomas: These cysts can grow quite large and press on nearby organs, causing pain and a feeling of fullness. They are most common in women over 60 and are rarely cancerous.

• Mucinous Cystic Neoplasms: These cysts are typically found in the middle or end part of the pancreas and are more common in middle-aged women. They can sometimes become cancerous, and larger cysts might already be cancerous when discovered.

• Intraductal Papillary Mucinous Neoplasms (IPMN): These growths develop in the main pancreatic duct or smaller branches. They can be precancerous or cancerous, and can affect both men and women over 50. Treatment might involve surgery depending on the cyst's location and other factors.

• Solid Pseudopapillary Neoplasms: These are rare, usually found in the middle or end of the pancreas, and are more common in women under 35. They can be cancerous.

• Cystic Neuroendocrine Tumors: These tumors are mostly solid but can have cyst-like parts. They can be difficult to distinguish from other pancreatic cysts and may be precancerous or cancerous.

Your doctor will consider all the information from the tests, your medical history, and your age and sex to determine the best course of action. If a cyst is found to be cancerous or potentially cancerous, treatment options will vary depending on the specific type of cyst and its characteristics.

Managing pancreatic cysts depends on several factors. The best approach—either watchful waiting or treatment—is determined by the type of cyst, its size, its appearance, and whether it's causing any problems.

A harmless cyst called a pseudocyst, even a big one, can often be safely ignored if it isn't causing discomfort. A type of cyst called a serous cystadenoma is also usually harmless and doesn't typically turn cancerous. These types of cysts can often be monitored, meaning they are checked regularly, instead of treated right away. However, if either of these cysts cause problems or grow significantly, then treatment is needed. Some other types of pancreatic cysts require regular monitoring to watch for changes.

If a pseudocyst is causing pain, discomfort, or getting bigger, it might need to be drained. A thin, flexible tube (endoscope) is inserted through your mouth and into your digestive tract. This tube has a special ultrasound tool (endoscopic ultrasound) and a needle to drain the fluid from the cyst. Sometimes, draining the cyst needs to be done through a small cut in the skin.

In some cases, a pancreatic cyst needs to be surgically removed because there's a risk of it becoming cancerous. Surgery might be necessary if a pseudocyst or serous cystadenoma is getting very large or is causing significant pain or other symptoms.

Important note: If you have a history of pancreatitis (inflammation of the pancreas), there's a chance a pseudocyst could come back (recur).