A Clinical Study on Pseudocyst of Pancreas

Abstract

Background: Pancreatic pseudocyst is seen in acute and chronic pancreatitis as a complication. It has a well-defined wall which is not made of epithelium. After an acute attack of pancreatitis, pancreatic pseudocyst develops after 4-8 weeks. There is a increased incidence of pancreatitis and complications of pancreatitis, despite of treatment and recent advances. So, I would like to study the clinical features, etiology, various treatment modalities and asses outcome of the patients. Methods: The study is conducted in 50 patients in S.V.R.R.G.G.H. hospital, Tirupati in the department of general surgery. Thorough history and clinical examination have been recorded. Investigations were done which are basic and definitive. The study patients were managed with different modalities like conservative, external catheter drainage, cysto-gastrostomy, cysto-jejunostomy, percutaneous drainage. Data regarding the age distribution, gender distribution, symptoms, signs, complications, treatment, post op complications, duration in the hospital, follow up were collected. The final outcome is observed in terms of most common age group, most common gender affected, most common etiological factor, symptoms, signs, associated complications and treatment, post complications in S.V.R.R.G.G.H. Tirupati, in the department of general surgery. Results: The study conducted in 50 patients shows that, the pancreatic pseudocyst is seen in the age group of 31-50 years (74%). The male patients were affected more when compared to females with 94% male and 3% female. Alcohol consumption is the common etiology. The most common presentation was pain abdomen in all study patients followed by nausea and vomiting in 84% of patients and abdominal distension in 58% of patients. Abdominal tenderness is seen in all study patients followed by mass abdomen in 60% of patients. Associated complications include infection which is seen in 12% of patients followed by ascites and ileus/obstruction in 2% of patients. USG and Computed Tomography done in all patients. Conservative treatment was effective in uncomplicated pancreatic pseudocyst. Internal drainage procedure shows good results with 42% of patients with minimal complications. The most common post operative complication include abdominal pain in 16% followed by infection of wound in 6% of patients. Conclusion: The most common complication of acute pancreatitis is pancreatic pseudocyst. Early diagnosis with USG, CT and intervention with conservative treatment for uncomplicated cyst, internal drainage for mature cyst, external drainage for complicated cyst shows good prognosis.