How Do Pancreatic Cysts Affect The Body & What Triggers It?

Pancreatic cysts occur in pancreatitis, though they are only reliably diagnosed 6 weeks after the episode of acute pancreatitis.(1)

About 10% of pseudocysts become infected. Pseudocysts can also rupture.(2)

How Do Pancreatic Cysts Affect The Body?

A pancreatic cyst is most commonly found as an incidental finding on radiological investigations such as contrast-enhanced computed tomography etc. These are asymptomatic and do not produce any discomfort to the patient. These are usually of the size less than 2 cm and do not carry any precancerous or cancerous tissue. These cysts do not require any urgent treatment and carry a conservative line of action with wait and watch strategy as the prime method of management.

But with the advent of more and more factors responsible for the creation of an environment which can irritate the pancreas and produce pancreatitis is leading to the formation of various types of pancreatic cysts. These can become symptomatic and the most common symptom is pain.

Pain can be vague and non-classified but sometimes it can be characteristic. Pain starts in the abdomen in the left hypochondrium region also involving the epigastrium and umbilical region sometime followed by the radiation of the same pain into the back in between the scapular areas. It is a very sharp pain and of piercing nature which is not relieved by simple analgesics like NSAIDs. Higher painkiller medications such as opioid analgesics have to be given like morphine, tramadol because only these are effective.

Other features depend upon the site and extent of involvement of the pancreas like if there is the involvement of the initial part of the pancreas along with the duct of wirsung then it can also compress the common bile duct and produce the symptoms of jaundice which is of obstructive type. The patient may present with the yellow stains of skin and sclera. If the size of the pancreatic cyst or pancreatic pseudocyst becomes very large such as greater than 5 cm then it can produce a mass effect and compress the surrounding organs like the stomach, duodenum, and the symptoms of vomiting can also be seen.

Sometimes there is an infection of the cyst leading to the production of systemic symptoms like malaise, weakness, generalized sickness, fever which may or may not be associated with chills depending upon the extent of infection. If the cyst turns malignant then the production of another type of symptoms like that of cancer are seen like generalized muscle wasting, weakness of the body, loss of weight, chronic fever and pain, multiple organ dysfunction, etc. which are non-specific for the pancreatic disease and can occur in any type of cancer.(3)

What Triggers Pancreatic Cysts?

There are a lot of triggering factors that have been detected now which are responsible for the pancreatic disease but only a few remain the most common ones. Firstly, the most common type of pancreatic cyst is pancreatic pseudocyst which is usually formed in the response of the episode of acute pancreatitis with the involvement of the pancreatic duct leading to its rupture and formation of a pseudo sac. The bout of acute pancreatitis is seen in cases with alcohol consumption in large doses or binging of alcohol, gallstone lodgement in the common bile duct, and trauma to the abdomen which can be a roadside accident, blunt trauma, sharp trauma, or iatrogenic trauma also.

Conclusion

Usually, pancreatic cysts are asymptomatic and do not affect the body in any manner and may remain in the same state for years or even lifetime. But it can produce a few of the symptoms if causes a surrounding injury to the tissue. The risk factor and triggers remain the same that is alcohol consumption, gallstone lodgement, and trauma to the abdomen.

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