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Q. My brother had an acute pancreatitis and CT shows pancreatic pseudocyst formation. Please help.

Answered by
Dr. Penchala Prasad Kandikattu
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 15, 2020

Hello doctor,

My brother is 43 years old. He had an episode of acute pancreatitis last year. Gas and indigestion persisted since then. A recent CT scan has shown a possibility of pancreatic pseudocyst formation.

The doctor has advised to remove the same by the procedure. My query regarding this is whether the pseudocyst can be treated by medicines or a procedure is recommended. And if yes, whether a laparoscopic procedure can be opted. What are the advantages and disadvantages? If there is a chance of the pseudocyst being formed again after the procedure?

I am currently on Atowa Aony, Prankeeatoflat, Sompray D, VSC 3#, and Telma AM.

#

Hello,

Welcome to icliniq.com.

When he had the first episode of pancreatitis? What is the size of the cyst by ultrasound? What is serum amylase or lipase levels? Is he a diabetic? Is he an alcoholic? Will you please answer to above questions if possible.

If pseudocyst usually acute means we will wait for four to six weeks for recovery. If it is not recovering with medication or increasing the size in sequential CT scans or it causing any complications (adjoining vessel compression or size > 5 cm or infected or causing bowel obstruction or symptoms of decreased appetite or weight loss) need surgery. Yes, you may undergo laparoscopic pseudocyst gastrostomy or cysto jejunostomy.

For this procedure need experienced hands and long term outcome not known. But less morbidity and success rate. Yes in 15-18% of causes recurrence.

Thank you doctor,

I have attached the CT scan and blood reports. Lipase level is 534 u/l. I am a borderline diabetic and no alcoholic.

#

Hello,

Welcome back to icliniq.com.

I undergone all of your reports (attachment removed to protect patient identity). The cyst size is 17 ×11×15 and it is compressing the adjoining structures so need an intervention. It is better to undergo endoscopic surgery to decompress the cyst. So please consult a surgical gastroenterologist near by he will examine and treat you accordingly.


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