In a 15-year period from 1993 to 2007, the annual incidence of cystic lesions of pancreas in adults was 2.4 per 10,000 inhabitants. Pancreatic cyst was the most common type of cystic pancreas lesion. Further studies are required to define the exact underlying genetics of pancreatic cyst genesis.
When a cyst in the pancreas ruptured with no associated injuries, a cystoperitoneal fistula and peritoneal sepsis, we were able to operate on the cyst. This is one of the few reports that surgical treatment can be applied for treatment of pancreatic cyst. We hypothesize that the surgical treatment can lead to improvement of symptoms and quality of life. But there are still few reports of the treatment for pancreatic cyst.
Signs of pancreatic cysts include loss of appetite, pain, nausea and vomiting. A palpable abdominal mass is a major presenting sign of pancreatic cysts. A non-enhancing mass on computed tomography (CT) imaging can be a sign of an extra-pancreatic source such as cancer or fluid collection.
The most common cause of a pancreatic cyst is ductal dilation following chronic pancreatitis. Other causes of pancreatic cyst include pancreatic cancer and intraductal papilloma.
A meta-analysis of existing randomized control trial literature was performed. Randomized controlled trials and case reports involving treatments were evaluated to determine the safety and efficacy of each treatment. The best clinical evidence for the treatment of pancreatic cyst is based on observational and retrospective studies.
Pancreatic cyst can be present all over the body, especially in the head of the pancreas and pancreatic duct (pancreatic head cyst). But, the pancreatic head cyst has a higher prevalence in developing countries, and the head of the pancreas cyst in developing countries is generally benign.
Use of EUS with Gd-EOB or Gd-DTPA for imaging of the pancreas for the purposes of [image-guided radiotherapy (IGRT) or [selective internal radiation therapy (SIIT)]] typically given without any other treatments has a significant role in pre- or post-procedure treatment planning. EUS-IGRT or EUS-SIIT seems to be the preferable technique for imaging the pancreas for use in any form of pre- or post-procedure treatment planning or of [image-guided surgery].
In this pilot study, contrast with eUS for the evaluation of pancreatic masses was safe and may be an alternative imaging modality when using MDCT.
Contrast-enhanced CT is useful for evaluating pancreatitis both in acute and chronic form. EUS-guided aspiration may help to rule out malignant masses that might persist or regress after adequate treatment.
Pancreatic cyst is a common disease affecting 1 in 1000 people from birth to age 60, but this number could increase with time. Considering the long period required for cyst onset, and the relatively benign course of the disease, most cysts remain asymptomatic, while some cause discomfort in the form of epigastric pain or intestinal obstruction. Families should be aware of a hereditary predisposition, when a personal or family history of pancreatic cysts or pancreatic cancer.
The use of various imaging techniques during follow-up imaging is effective in the evaluation of pancreatic cysts and for predicting the prognosis of pancreatic cyst diseases. Further research is needed on the use of magnetic resonance imaging for predicting the recurrence of pancreatic cysts.
Contrast-enhanced endoscopic ultrasonography with ultrasonography is an effective tool for achieving the diagnosis of pancreatic cysts, especially pancreatic cyst, and was proven to be more effective than a placebo treatment.