Pseudocyst
Pseudocyst | |
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Respirology |
Pseudocysts are like
This is not to be confused with the so-called "pseudocystic appearance", mainly
.Signs and symptoms
Pseudocysts are often asymptomatic. Symptoms are more common in larger pseudocysts, though the size and time present usually are poor indicators of potential complications.[2]
Pancreatic pseudocysts may cause
Adrenal pseudocysts may cause abdominal pain, along with various
Cause
Pancreatic pseudocysts are often caused by acute or chronic
Types of adrenal cysts include parasitic cysts, epithelial cysts, endothelial cysts, and pseudocysts. 56% of all adrenal cyst-like changes are pseudocysts, and only 7% of those pseudocysts are malignant or potentially
The cause of adrenal pseudocysts is unknown. A few theories exist, but it is believed that repeated episodes of trauma, infection, or bleeding may cause collagen formation leading to the formation of a fibrous lining.[4]
Retinal pseudocysts may be related to geographic atrophy. A study found that 22% of eyes with geographic atrophy contained pseudocysts.[6]
In American trypanosomiasis (
Diagnosis
Description
A pseudocyst is a cystic lesion that may appear as a cyst on scans, but lacks epithelial or endothelial cells.
Pancreatic pseudocysts
The most common and effective method of diagnosing a pancreatic pseudocyst is with a
Transabdominal ultrasound can be used to identify pseudocysts, which appear on the scan as echoic structures associated with distal acoustic enhancement. They tend to be round and enclosed in a smooth wall. Pseudocysts may appear more complex when young, hemorrhaged, or when complicated due to infection. The transabdominal ultrasound has a sensitivity rate in detection of pancreatic pseusocysts of 75%-90%, making it inferior to a CT scan, which has a rate of 90%-100%.[2]
Endoscopic ultrasound is generally used as a secondary test to further evaluate the cysts found in other tests, and is used when determining if a cyst is a pseudocyst or not.[2]
Adrenal pseudocysts
Adrenal pseudocysts are found in much the same way as pancreatic pseudocysts, with CT scans. In addition, adrenalectomies are used to diagnose the lesion and sometimes relieve pain.[4]
Prevention
Because pseudocysts are closely related to other conditions, such as pancreatitis and alcohol use, the prevention of pseudocysts lies in the prevention of the main problem.[5]
Treatment
Not all cysts require treatment. Many pancreatic pseudocysts improve and disappear by themselves. If the cysts are small and are not causing symptoms, careful observation with periodic CT scans is often done. Pseudocysts that persist over many months or that cause symptoms require treatment.[3]
Supportive medical care used to help small pseudocysts go away includes the use of
Percutaneous drainage involves the guidance of a CT scan or ultrasound. A drainage catheter is placed into the fluid cavity to drain the fluid, which is then collected over several weeks into an external collection system. The catheter is removed when the drainage becomes minimal. Once the catheter is removed, contrast is injected into the cyst cavity to determine the remaining size and to monitor progress. The success rate is around 50%, and the unsuccessful drainages are mostly caused by large ductal leaks or blockage of the main pancreatic duct. This method is not recommended when patients cannot manage a catheter at home or with patients whose cysts contain bloody or solid material.[2]
Surgical drainage of a pseudocyst involves creating a pathway between the pseudocyst cavity and the stomach or small bowel. This method is generally only used if the patient cannot tolerate or failed percutaneous or endoscopic drainage. This method is more risky than the others.[2]
Endoscopic drainage is becoming the preferred method of draining pseudocysts because it is less invasive, does not require external drain, and has a large long-term success rate. Drainage is usually achieved with a
The endoscopic method depends on the presence of a bulge into the stomach or duodenum to determine the site for
To treat adrenal pseudocysts, an adrenalectomy or laproscopy may be used.[4]
References
- PMID 22118925.
- ^ PMID 19115466.
- ^ a b c d "Pancreatic Pseudocysts". Center for Pancreatic and Biliary Diseases; USC Department of Surgery.
- ^ PMID 17004872.
- ^ a b MedlinePlus Encyclopedia: Pancreatic pseudocyst
- PMID 20537310.
- ISBN 978-0-470-65853-6.