Etiology, clinical presentation and management of pancreatic pseudocyst

Abstract

Background: The clinical presentation of pseudocyst is varied among individuals and so does the spectrum of management ranging from resolution to open or minimal access/ endoscopic drainage procedures. This study aims to review the various etiological factors, mode of clinical presentation of pseudocyst in relation to age and sex, and to study various modalities of investigation & management of pseudocysts.Methods: In this prospective study, 31 diagnosed patients of pseudocyst of pancreas were included who underwent different biochemical and radiological investigations. The study duration was 2 years from November 2016 to October 2018 carried out at a tertiary care hospital and the management and outcome of these patients were studied.Results: Males (93.54%) were the predominating gender suffering from pseudocyst and alcohol consumption (70.96%) was the most common etiological factor. 67.74% of patients had pseudocyst formation after recurrent attacks of pancreatitis. 20 patients (64.51%) patients were managed conservatively with complete resolution of pseudocyst in 10 patients. In rest of the 11 patients, 7 patients underwent open internal drainage, 2 patients underwent endoscopic internal drainage and pancreatic duct stenting; in one patient, external drainage was performed and another patient distal pancreatic resection was done.Conclusions: Pseudocyst of pancreas is predominantly seen in males with alcohol consumption being the commonest etiological factor. Spontaneous resolution of pseudocyst occurs in most of the patients and symptomatic patients can be managed by intervention by open/endoscopic internal drainage with or without pancreatic stenting and external drainage should be reserved for infected pseudocysts.