Pancreatic cysts are abnormal growths in the pancreas. Such growths appear in the form of bubbles. A distinction is made between pseudocysts and real cysts. They can be removed without surgery.
What is a pancreatic cyst?
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The real cysts are made up of epithelium. Epithelium is one of the four basic types of tissue that occurs in many different places in the body and is completely normal. The epithelium does not contain any blood vessels or pancreatic enzymes such as lipase and amylase and consists of very small, densely packed cells.
Real cysts are less common than pseudocysts. There are three different forms of real cysts: The so-called congenital cysts are congenital, i.e. hereditary cysts. Retention cysts tend to occur in chronic pancreatitis and are formed from constrictions and bulges in passages of the pancreas.
The third form, the so-called neoplastic cysts, consist of tumor tissue and can only be distinguished from pseudocysts by closer examination and removal of tissue. They cannot be assessed by imaging methods such as sonography.
causes
The pseudocysts that result from injuries to the pancreas or from acute pancreatitis are bordered by scar-like tissue. They contain pancreatic enzymes (lipase and amylase), which ensure that the pancreatic tissue can digest itself. Serum or blood is sometimes found inside them in association with dead tissue.
Pancreatic cysts can in some cases be hereditary.
True cysts are either congenital, arise from chronic pancreatitis or arise from pancreatic pancreatic protrusions.
Symptoms, ailments & signs
A pancreatic cyst manifests itself at the beginning by unspecific symptoms such as tiredness, fever or gastrointestinal complaints. Those affected suffer more from nausea and vomiting or gas. There is also often vomiting of blood. This is accompanied by severe pain in the abdomen, which can radiate into the back and abdomen.
Larger cysts cause abdominal pain through to cramps and colic. If the cysts have metastasized in the abdomen, this can be recognized by the palpable growths. In individual cases a pancreatic cyst runs completely symptom-free. Sick people only notice the tumor in the late stage, when they feel pressing pain, abdominal cramps and external signs such as ascites.
An untreated pancreatic cyst can lead to sepsis. This manifests itself among other things as a rising fever, severe pain and fatigue. If the bile duct is pinched it can cause jaundice, which is manifested by exhaustion and fever, and yellowing of the skin and conjunctiva of the eyes.
In addition, a malignant pancreatic carcinoma can develop from the cyst. The symptoms of the pancreatic cyst develop gradually, often over the course of weeks or months. When the sick person notices the condition, the cyst is often well advanced.
Diagnosis & course
Signs of a Pancreatic cyst can be non-specific symptoms such as general weakness, weakness of the heart, flatulence, fainting, chills, fever, vomiting and nausea, vomiting of blood, pain in the back up to clouded consciousness.
With larger cysts it is not uncommon for abdominal pain that can lead to colic. In some cases, pancreatic cysts develop into tumors that can also be felt over the abdomen. In many cases, however, there are no symptoms at all.
In most cases, pancreatic cysts can be detected using the imaging technique of sonography. Sometimes computed tomography, ERCP, or angiography is needed. In the event of an injury to the pancreas, the lipase and amylase can be determined by abdominal irrigation, a so-called lavage.
Complications
If there is a pancreatic cyst in the pancreas, this can lead to serious complications. The risk is particularly high if the pseudocyst is acute or has a pronounced size. The most common sequelae of the pancreatic cyst are infections.
These often cause abscesses. These are encapsulated cavities that are filled with pus. There is also an increased risk of inflammation of the peritoneum (peritonitis). A concomitant phenomenon is the development of a so-called water belly, which is caused by a massive accumulation of fluid in the abdomen. Doctors speak of ascites in this case.
Furthermore, the infections can lead to life-threatening blood poisoning (sepsis). Bleeding is another common complication. In the worst case, the bleeding causes a drop in hemoglobin, which in turn has acute life-threatening effects. Obstructive cholestasis is also one of the sequelae of the pancreatic cyst.
If the bile duct is compressed, a pancreatic pseudocyst located in the head of the pancreas can cause jaundice (jaundice). In addition, the gallbladder fills up. In medicine, a bulging gallbladder, which is associated with painless jaundice, is also considered a suspicion of a pancreatic tumor (pancreatic cancer). Another serious complication of the pancreatic cyst is the development of a pancreatic carcinoma. The risk of the pancreatic cyst becoming malignant increases with age.
When should you go to the doctor?
Recurring colic, swelling in the upper abdomen, and pain indicate a pancreatic cyst. A doctor's visit is advisable if the symptoms do not go away on their own within a week. If the symptoms get worse or if there are additional symptoms, it is best to call a doctor immediately. The same applies to serious complications such as fever or pain attacks. The family doctor should then be contacted immediately. Bleeding, abscesses and signs of jaundice are also serious warning signs that should be clarified immediately by a doctor. It is best for those affected to call the rescue service so that treatment can be initiated as soon as possible.
Anyone who eats an unhealthy diet or generally leads an unhealthy lifestyle with an unbalanced diet and little physical exercise is particularly at risk of developing a pancreatic cyst. People with previous illnesses such as pancreatic cancer or necrosis in the pancreas are also among the risk patients and should have the symptoms clarified by a doctor immediately. A pancreatic cyst is treated by a family doctor or a gastroenterologist. Nutritionists and physiotherapists can be called in during treatment. Follow-up care is carried out by the gastroenterologist and later by the family doctor. In the event of unusual symptoms, the responsible doctor must be informed. Treatment at a pancreatic center is indicated for serious illnesses.
Treatment & Therapy
If cysts develop as a result of pancreatitis, careful observation of the unwanted growth is indicated first. In many cases the cysts resolve on their own and disappear after a while without causing any further discomfort.
If the patient complains about the cyst, drainage can be performed. A hole is cut through the duodenum or stomach in this case, through which a gastroscope can be inserted. Such a hole is kept open by a stent, a special plastic tube, and the fluid inside the cyst can then gradually drain away.
It usually doesn't take more than three months for the cyst to empty, the outer walls of the cyst to stick together and to go away. Only after this process can the plastic tube be removed again. In rare cases where a cyst is filled with pus, it must be emptied using an endoscope.
This can also remove dead tissue that may be inside the cyst. Thanks to the procedure with the help of the stent or a gastroscope, it is not necessary to remove a cyst with an operation.
Treatment of the pancreatic cysts can, however, lead to complications such as unwanted bleeding or the formation of abscesses. Relocation of the duodenum is also possible, or jaundice, i.e. jaundice.
Complete restoration of the patient's health after treatment of a pancreatic cyst is given with a chance of success of about 60 percent.
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With the use of medical care, the prognosis for a pancreatic cyst is favorable. The cyst can be completely removed with surgery or other less risky techniques. Immediately after the wound has healed, the affected person can be released from the treatment as healed. The challenge is to diagnose the disease. The cyst often goes unnoticed for a longer period of time, as it usually causes little or no diffuse symptoms. However, once the diagnosis is established, the unwanted tissue should be removed.
Otherwise, an unfavorable course of the disease can lead to the development of a life-threatening situation. Bleeding in the pancreas is possible, which can lead to complications and serious health changes. There is also the risk that the tissue can mutate. In these patients, the otherwise favorable prognosis is considerably worsened. Rather, it can lead to a shortening of the expected lifetime. If medical care is therefore denied, the outlook for those affected changes considerably. The earlier the diagnosis is made, the better the further course.
Despite the fact that the patient has recovered and is free of symptoms, the cyst can develop at any time over the life span. The prognosis remains unchanged in these cases as well.
prevention
There are no direct preventative measures against Pancreatic cysts. Doctors only recommend a healthy lifestyle through a high-fiber diet and lots of sport and exercise.
Aftercare
If the person has a pancreatic cyst, they should consult a doctor at an early stage so that there are no other complications or further worsening of the symptoms. The sooner a doctor is contacted, the better the further course of the disease is usually, since self-healing usually cannot occur with this disease.
The measures and options for direct follow-up care for a pancreatic cyst are also relatively limited. The complaint itself can be relieved relatively easily with a minor surgical intervention. In most cases, there are no further complications or other complaints.
The affected person should take care of their stomach and intestines after such an operation and avoid fatty food. Only after a while can the diet be adjusted again. As a rule, regular check-ups and examinations by an internist after the procedure are very important in order to identify and treat other complaints at an early stage.
You can do that yourself
People with a pancreatic cyst are often worried and excited. If the cyst is less than 2 cm, the patient helps himself most by staying calm. If the diagnosis was made on the basis of an incidental finding and there are no other symptoms due to the presence of the cyst, there is usually little cause for concern.
Stress, inner excitement and hectic rush are to be avoided. They reduce well-being and lead to psychological problems. The use of various relaxation techniques can be helpful in order to achieve an inner balance. A cyst can mutate into a malignant tumor at any time. However, the likelihood of a small pancreatic cyst is very small. Since there is a possibility that a small cyst will detach itself later and be transported away by the organism, further observation should take place first. Regular MRI check-ups and good self-awareness are important in these situations.
If the person concerned notices changes or has a feeling of illness, he should initiate a check-up visit to a doctor. Comprehensive information about the disease is important so that the patient can make good and correct decisions for himself as it progresses. In addition, the organism should be strengthened and supported by a balanced diet and sufficient exercise.
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