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Pancreatic cysts
Medical expert of the article
Last reviewed: 04.07.2025
A pancreatic cyst is a very common pathology. A cyst is a formation in the tissues (parenchyma) or outside the gland of isolated cavities (capsules) with liquid contents. It includes the digestive secretion of the pancreas, as well as decayed necrotic tissues (tissue detritus).
Depending on the etiology, a pancreatic cyst can be true (congenital) or false (acquired). Depending on the location of the cavity in the organ, there are: a cyst of the head of the pancreas, a cyst of the body of the pancreas, and a cyst of the tail of the pancreas.
[ Causes of pancreatic cysts
True pancreatic cyst (or dysontogenetic cyst) is the result
Congenital developmental disorders of this organ. Inside, the true cyst is lined with epithelium. This disease is diagnosed quite rarely, since the size of a true pancreatic cyst is usually insignificant. Therefore, it does not press on the surrounding tissues and organs and does not cause any complaints. As practice shows, such a cyst is discovered completely by accident - during an ultrasound scan that a person undergoes for any other disease.
However, if a true pancreatic cyst is formed as a result of congenital blockage of the gland's ducts and accumulation of secreted fluid in them, then chronic inflammation develops with the formation of fibrous tissue - cystic fibrosis of the pancreas or cystic fibrosis.
A false pancreatic cyst (pseudocyst) is lined internally not with epithelium, but with fibrous and granulation tissue. The causes of false cysts include trauma to the pancreas, inflammatory diseases (pancreatitis, chronic pancreatitis, pancreatic necrosis), and pancreolithiasis, in which stones formed in the gland can block the ducts, which gives rise to the development of a so-called retention cyst.
According to medical statistics, 90% of cases of false pancreatic cysts are a consequence of acute pancreatitis, and 10% of cysts appear as a result of pancreatic trauma. Of these, up to 85% are pancreatic body cysts or pancreatic tail cysts, 15% are pancreatic head cysts.
It should be noted that with excessive consumption of fatty and fried foods and alcohol abuse, the risk of developing a pancreatic cyst increases. Thus, in 60-70% of patients with primary chronic alcoholic pancreatitis, a false pancreatic cyst develops.
Symptoms of pancreatic cyst
A characteristic symptom of a pancreatic cyst is constant or paroxysmal pain in the epigastric region (that is, in the area where the stomach projects onto the anterior abdominal wall) and in the right or left hypochondrium.
Often, pain is felt in the navel area. The pain can radiate to the back (since the pancreas is located on the back abdominal wall), as well as to the left arm and shoulder. In many cases, the pain ceases to be local and becomes encircling, and its strength increases many times over. The most severe pain occurs when the pancreatic cyst presses on the celiac and solar plexuses.
When palpating, another symptom of a pancreatic cyst is revealed - a painful, voluminous formation in the epigastric region or on the left under the ribs. If the cyst has reached a significant size, patients themselves see a pathological "bulge" in the upper abdomen. In addition, patients complain of a feeling of heaviness in the abdomen, belching and heartburn.
An enlarged pancreatic cyst begins to press on adjacent organs, disrupting their normal functioning. For example, a cyst of the head of the pancreas can compress the bile duct, resulting in stenosis of the duodenum, nausea, vomiting, and mechanical jaundice. And compression of the main pancreatic duct leads to dyspepsia (indigestion), diarrhea (frequent loose stools), and very severe pain. In this case, acute pancreatitis is diagnosed.
An accompanying infection that leads to the formation of purulent masses inside the cyst causes fever, chills and general weakness. In fact, this is an abscess of the cyst. In this course of the disease, the pancreatic cyst perforates: the cavity ruptures, causing bleeding (cyst perforation), and its purulent contents enter directly into the abdominal cavity. Symptoms of this condition are sharp pain, cold sweat and loss of consciousness. This can lead to inflammation of the abdominal cavity - peritonitis, which is life-threatening and requires emergency medical care. According to clinical practice, a rupture of a pancreatic cyst, which is accompanied by bleeding, leads to death in more than 60% of cases.
Where does it hurt?
Diagnosis of pancreatic cysts
The main method used to diagnose pancreatic cysts is ultrasound examination (US). During the abdominal examination, the gastroenterologist evaluates the condition of the pancreas and surrounding organs, determines the presence of a pathological cavity and determines its location, shape and size.
In order to differentiate pancreatic cysts from chronic pancreatitis, malignant tumors of the gland itself and neighboring organs, abdominal aortic aneurysms, ovarian cysts, etc., magnetic resonance imaging (MRI) is used.
If a biochemical, cytological and microbiological examination of the contents of a pancreatic cyst is necessary, a puncture is performed through the anterior abdominal wall, monitoring the diagnostic procedure using ultrasound or CT.
A laboratory test of blood parameters (hemoglobin and hematocrit) is carried out, which is necessary to determine the presence of hidden bleeding in the cavity of the false cyst.
What do need to examine?
What tests are needed?
Treatment of pancreatic cysts
The treatment tactics for pancreatic cysts are determined by such indicators as:
The stage of its development, the peculiarities of the connection with the pancreatic duct and, of course, the presence and nature of complicating factors.
If the cyst does not exceed 3-5 cm and the disease proceeds without complications, painkillers and a diet with limited fats and proteins are prescribed according to indications. Monitoring of the patient's condition lasts approximately 1.5 months. If the cyst does not increase, the patient is prescribed a diet and systematic (1-2 times a year) ultrasound - to monitor the dynamics of the pathological process.
It should be taken into account that a false cyst of the pancreas with a diameter of 6 cm or more is rarely cured without the help of surgeons and, moreover, has a clear tendency to increase and the appearance of various complications: rupture, bleeding, pancreatic abscess.
However, clinical practice in recent years shows that a false cyst of the pancreas in acute pancreatitis spontaneously resolves in a third of patients 3-4 months after the attack. But a cyst in chronic inflammation of the pancreas rarely disappears on its own...
Surgical treatment of pancreatic cysts primarily involves removing the contents from its cavity (drainage). Laparoscopic drainage is widely used for this purpose – a modern minimally invasive technique in which intervention in the abdominal cavity is carried out through small openings. Such drainage of pancreatic cysts gives minimal complications, but it is possible only in the absence of suppuration.
If there is inflammation of the cyst with the release of pus or all signs of compression of the common bile duct are present, then the patient undergoes laparotomy (cavity) opening of the cyst and its endoscopic transpapillary, transgastric or transduodenal drainage.
In cases where the cyst completely blocks the pancreatic duct, a cavity operation called cystenterostomy is performed: first, the cystic cavity is opened and emptied of its contents, then it is treated with appropriate drugs, and finally an anastomosis (connection) is formed with the small intestine.
In some cases - when the cyst is small, mobile and has well-formed walls - the pancreatic cyst is removed (extirpation). A very complex operation for radical removal of the cyst is resection of part of the pancreas. But this type of surgical treatment of the pancreatic cyst often does not give the expected effect, and it is used only when the cyst undergoes malignant degeneration.
Prevention of pancreatic cysts
As with other pathologies of the digestive system and gastrointestinal tract, the quality and regimen of nutrition play an important role in the prevention of pancreatic cysts.
A diet for pancreatic cysts involves excluding foods that contain a large amount of fats and carbohydrates, all fried, fatty and spicy foods. Start eating healthy foods, primarily fresh vegetables and fruits. You should eat more often, but in small portions.
Inflammatory processes in the stomach and duodenum should be treated, and gallstones should be eliminated. Nutritionists recommend eating more grapes, which help normalize the functions of the pancreas.
The pancreas is also harmed by: thoughtless use of medications for self-medication, smoking, alcohol, a sedentary lifestyle and stress.
When diagnosed with a pancreatic cyst, the prognosis is not very encouraging. Avoiding surgery is very problematic, since the cyst is prone to inflammation. And the inflammatory process in a closed cavity can reach such proportions that only an urgent operation can save a life.