Aetiology and Prognosis of Pancreatic Pseudo Cysts Over A 10 Year Period

Volume 3 - Issue 1

Maged Farag*, Xavier Escofet and Nader Naguib

Received:June 19, 2019;   Published: June 28, 2019

DOI: 10.32474/SCSOAJ.2019.02.000152

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Abstract

Introduction: Pancreatic pseudocysts often arise as a complication of acute or chronic pancreatitis with reported prevalence in chronic pancreatitis of 20-40%. Most common cause is alcoholic chronic pancreatitis (70-78%) then idiopathic chronic pancreatitis (6-16%), then biliary pancreatitis (6-8%). The aim of this study is to assess the demographic characteristic of patients diagnosed with pseudocysts, aetiology, characteristic features, and prognosis.

Methods: Prospective observational study to follow up patients diagnosed with pancreatic pseudocyst in 5 years (2006-2011). Data was collected in 2011 and patients followed up till June 2019. Radiology database searched for all cases that had a diagnosis confirmation by Computerised Tomography (CT). Total of 167 CT carried out for 119 patients. 35 patients were excluded due to absence of pancreatic pseudocyst after radiological re-evaluation

Results: In 5 years, 84 patients diagnosed with pancreatic pseudocysts on CT. 127 CT scans done mainly for follow up. 51(60.7%) males and 33 (39.3%) females; mean age= 57.8 years (20-93). 41 cases (48.8%) were associated with acute pancreatitis (8 on background of chronic pancreatitis). 21 cases (25%) were associated with chronic pancreatitis, 4 were associated with pancreatic malignancy while 18 (21.4%) were reported as incidental finding. The underlying factor was alcoholic pancreatitis in 37 patients (44%), gall stones in 19 patients (22.6%), pancreatic malignancy in 4 (4.8%) patients, biliary strictures in 2 patients and trauma in 2 patients. Idiopathic pancreatic pseudocysts were seen in 20 patients (23.8%), 18 of them were incidentally found on CT scan. 8 cases (40%) of idiopathic pseudocysts, were associated with non-pancreatic malignancies. 50% mortality (42 patients). 17 had acute pancreatitis, 15 had chronic pancreatitis, 6 were from the incidental finding and 4 from acute on top of chronic group. As for aetiology, 25 patients of the 42 had alcoholic pancreatitis, 12 had gall stones pancreatitis, 3 were unknown aetiology and 2 had pancreatic cancer.

Conclusion: Our study showed that alcoholic pancreatitis remains the most frequent underlying aetiology for pancreatic pseudocysts although it is not as common as previously reported. Idiopathic pseudocysts constituted a substantial number of this study with a higher than expected incidental pseudocysts. The association of pancreatic pseudocysts with malignancy needs to be further evaluated.

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