Pancreatic cysts are saclike pockets of fluid on or in your pancreas. The pancreas is a large organ behind the stomach that produces hormones and enzymes that help digest food. Pancreatic cysts are typically found during imaging testing for another problem.
The main categories of pancreatic cysts can be divided into two groups, nonneoplastic or neoplastic cysts. Each group includes many different subtypes of cysts, such as pseudocysts, serous cystadenomas and mucinous cystic neoplasms. Most aren't cancerous, and many don't cause symptoms. But some pancreatic cysts can be or can become cancerous.
Your doctor might take a sample of the pancreatic cyst fluid to determine if cancer cells are present. Or your doctor might recommend monitoring a cyst over time for changes that indicate cancer.
You may not have symptoms from pancreatic cysts, which are often found when imaging tests of the abdomen are done for another reason.
When signs or symptoms of pancreatic cysts do occur, they typically include:
Rarely, cysts can become infected. See a doctor if you have a fever and persistent abdominal pain.
A ruptured pancreatic cyst can be a medical emergency, but fortunately is rare. A ruptured cyst can also cause infection of the abdominal cavity (peritonitis).
The cause of most pancreatic cysts is unknown. Some cysts are associated with rare illnesses, including polycystic kidney disease or von Hippel-Lindau disease, a genetic disorder that can affect the pancreas and other organs.
Pseudocysts often follow a bout of a painful condition in which digestive enzymes become prematurely active and irritate the pancreas (pancreatitis). Pseudocysts can also result from injury to the abdomen, such as from a car accident.
Heavy alcohol use and gallstones are risk factors for pancreatitis, and pancreatitis is a risk factor for pseudocysts. Abdominal injury is also a risk factor for pseudocysts.
The best way to avoid pseudocysts is to avoid pancreatitis, which is usually caused by gallstones or heavy alcohol use. If gallstones are triggering pancreatitis, you may need to have your gallbladder removed. If your pancreatitis is due to alcohol use, not drinking can reduce your risk.
Pancreatic cysts are diagnosed more often than in the past because improved imaging technology finds them more readily. Many pancreatic cysts are found during abdominal scans for other problems.
After taking a medical history and performing a physical exam, your doctor may recommend imaging tests to help with diagnosis and treatment planning. Tests include:
The characteristics and location of the pancreatic cyst, along with your age and sex, can sometimes help doctors determine the type of cyst you have:
Watchful waiting or treatment depends on the type of cyst you have, its size, its characteristics and whether it's causing symptoms.
A benign pseudocyst, even a large one, can be left alone as long as it isn't bothering you. Serous cystadenoma rarely becomes cancerous, so it also can be left alone unless it causes symptoms or grows. Some pancreatic cysts should be monitored.
A pseudocyst that is causing bothersome symptoms or growing larger can be drained. A small flexible tube (endoscope) is passed through your mouth to your stomach and small intestine. The endoscope is equipped with an ultrasound probe (endoscopic ultrasound) and a needle to drain the cyst. Sometimes drainage through the skin is necessary.
Some types of pancreatic cysts require surgical removal because of the risk of cancer. Surgery might be needed to remove an enlarged pseudocyst or a serous cystadenoma that's causing pain or other symptoms.
A pseudocyst may recur if you have ongoing pancreatitis.
Here's some information to help you get ready for your appointment.
Some basic questions include:
Don't hesitate to ask other questions, as well.
Your doctor is likely to ask you questions about your symptoms, such as:
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