What is the definition of “pancreatic pseudocyst”?
➥ Pancreatic pseudocyst → is a formation of the retroperitoneal space due to the inflammatory process caused by acute pancreatitis.
- In up to 10% of patients with acute pancreatitis, retroperitoneal acute fluid collections progress to develop a wall of fibrous granulation tissue, at which point they are classified as pseudocysts.
Cullen's sign
Acute Pancreatitis Dx
- Typical abdominal pain radiating back
- Serum Amylase or lipase 3x > N
- Imaging CT or US
- Amylase - Not specific
- lipase - specific
- AST/ALT - hepatocellular injury
- GGT/ALP - cholestatic enzymes (bile duct obstruction)
- Bilirubin -?
- WBC, CRP, WBC, glucose, BUN -?
Tx
- NPO
- IV fluids resuscitation + electrolytes
- Pain control (Not morphine - sphincter of Oddi) Fentanyl
- Monitor
- PPI or H2 blocker → stop stomach triggering duodenal secretions
- Abx - prophylaxis
- Anti emesis
- Statins
Which are the differences between “pancreatic pseudocyst” and “pancreatic cyst”?
➥ Pseudocysts → don’t have epithelium-lined walls and most importantly they aren’t exactly cysts of the pancreas (they are formation of retroperitoneal space due to the inflammatory process caused by acute pancreatitis).