Pancreatic cysts

Pancreas is a large organ located behind the stomach in the abdomen, secreting digestive enzymes, and hormones which help to convert food into energy. A pancreatic cyst is a closed saclike pocket filled with fluid and is located on or in the pancreas. These cysts can be either benign (non-cancerous) or malignant (cancerous). The pancreatic cysts remain asymptomatic and are typically found during imaging testing for other health conditions. Pancreatic cysts result from rare diseases, such as von Hippel-Lindau disease.

Pancreatic cancer is the twelfth most common cancer in the world, with 338,000 new cases diagnosed in the year 2012.

Types of pancreatic cysts

Pancreatic cysts are of nearly 20 types. Some of the most important types include:

Pseudocysts – These are mostly made of fluid, and you may be at a risk of developing them if you have had a history of pancreatitis or pancreatic injury.

Serous Cystadenomas (SCAs) – These are benign cysts containing fluid with thick, fibrous walls. They may cause pain, jaundice, or make you feel uncomfortable as they grow.

Intraductal Papillary Mucinous Neoplasms (IPMNs) – These are the most common type of pancreatic cysts which develop within the ducts connecting pancreas to the intestines. The cells of the cysts produce a large amount of proteins that form mucus.

Mucinous Cystic Neoplasms (MCNs) – These are precancerous growths that start in the body and tail of the pancreas and more commonly seen in women rather than men.

Pancreatic cysts are usually asymptomatic. Some patients may have fewer symptoms that may occur days to months following a pancreatitis attack such as:

  • Severe and persistent pain in the abdomen, sometimes at the back
  • Nausea and vomiting
  • Abdominal bloating
  • A mass of tissue can be felt in the upper abdomen

In some cases, cysts can become infected. Call your doctor immediately if you notice fever, persistent and severe abdominal pain, weak and rapid heartbeat, decreased consciousness, and blood in vomiting.

The exact cause of pancreatic cyst is still not known. Some cysts are believed to be associated with rare illness such as von Hippel-Lindau disease which is a genetic disorder affecting the pancreas. Pseudocysts often result from injury to the abdomen, such as an auto accident.

Heavy alcohol and gallstones increase the risk of pancreatitis, which in turn increases the risk for formation of pancreatic cysts.

The growth of pancreatic cysts is associated with the development of few complications which include:

  • Infection, which may also lead to pancreatic abscess
  • Pseudocyst rupture (breaking open or bleeding of the cyst which may be life-threatening)
  • Obstructive jaundice may occur when a large cyst blocks the common bile duct, causing yellowing of the skin, mucous membrane, and eyes
  • Increase in blood pressure of the portal veins requiring surgery

Pancreatic cysts are hard to diagnose as the symptoms resemble many other disease conditions. The medical history of the patient is first assessed, and other diagnostic tests are recommended:

  • CT scan – provides detailed information about the size and structure of the pancreatic cyst
  • MRI scan – gives detailed information about the cyst, including whether the components of the cysts could cause cancer
  • Endoscopic ultrasound – fluid is collected from the cysts to check the possible signs of cancer

Pancreatic cysts are benign and may not require any treatment and can be left as such if it isn’t bothering you. But certain treatment options are recommended to prevent complications.

Drainage – endoscope, equipped with a needle is passed through the mouth into your stomach and small intestine to drain the cyst.

Surgery – this is recommended if the cyst is larger than 3 cm in size, if the cyst has a solid component, if the pancreatic duct is widened, and if the cysts are growing and causing pain. The whole of pancreatic cysts are removed, either via open surgery or laparoscopic surgery.

The risk of formation of pancreatic cysts can be reduced by minimizing or avoiding alcohol intake. Alcohol intake may be directly responsible for the condition pancreatitis (inflammation of the pancreas), and indirectly for the formation of pancreatic cysts.