Pancreatic Pseudocysts Clinical Presentation

  • Author: Louis R Lambiase, MD, MHA; Chief Editor: Julian Katz, MD   more...
 
Updated: Nov 17, 2011
 

History

  • No specific set of symptoms is pathognomic of pseudocysts; however, consider the possibility of a pseudocyst in a patient who has persistent abdominal pain, anorexia, or abdominal mass after a case of pancreatitis.
  • Rarely, patients present with jaundice or sepsis from an infected pseudocyst.
  • Pleural effusion is also a common finding.
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Physical

  • The sensitivity of physical examination findings is limited.
    • Patients very frequently have a tender abdomen.
    • Patients occasionally have a palpable mass in the abdomen.
  • Peritoneal signs suggest rupture of the cyst or infection.
  • Other possible findings include the following:
    • Fever
    • Scleral icterus
    • Pleural effusion
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Causes

Acute or chronic pancreatitis or abdominal trauma causes pseudocysts. If no history of pancreatitis or trauma exists, the diagnosis must be carefully confirmed.

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Contributor Information and Disclosures
Author

Louis R Lambiase, MD, MHA  Professor of Medicine, University of Tennessee College of Medicine Chattanooga; Chief, Division of Gastroenterology, University of Tennessee Chattanooga Unit; Assistant Dean for Clinical Affairs, University of Tennessee College of Medicine Chattanooga

Louis R Lambiase, MD, MHA is a member of the following medical societies: American Gastroenterological Association, American Pancreatic Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Specialty Editor Board

David Greenwald, MD  Associate Professor of Clinical Medicine, Fellowship Program Director, Department of Medicine, Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine

David Greenwald, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and New York Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Simmy Bank, MD  Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

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Three views of a pancreatic pseudocyst noted during endoscopic ultrasound. The concentric rings in the center of the images are the ultrasound transducer in the stomach. The cyst is observed as the large hypoechoic structure adjacent to the transducer.
These photographs show the endoscopic view of transpapillary pseudocyst drainage in a patient with pancreas divisum and a pseudocyst that communicates with the pancreatic duct. The image on the right shows the ampullary area. The middle image shows a wire placed in the minor papilla into the dorsal pancreatic duct. The left image shows a stent in place in the minor papilla.
 
 
 
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