What are pancreatic cysts?

Pancreatic cysts are balloon-like sacs of fluid that grow in or on the pancreas. The pancreas is an important organ involved indirectly in the digestive process. It is located in the abdomen, behind the stomach and it produces many enzymes and hormones. Cysts on the pancreas often cause no symptoms and are normally discovered accidentally during tests carried out on the abdominal region for another purpose. Due to the improvement in technology in recent years, cysts are now being detected more frequently.   

What causes pancreatic cysts?

The cause of pancreatic cysts is unknown. Some are associated with rare, genetic illnesses such as von Hippel-Lindau disease, whereas others often grow as a result of pancreatitis (inflammation of the pancreas). Risk factors that can increase the likelihood of someone developing a pancreatic cyst include excess alcohol consumption, frequent gallstones and abdominal injury. 

What are the symptoms of pancreatic cysts?

Generally, pancreatic cysts are symptomless. However, when signs of these cysts do occur, they are usually:  

• Abdominal bloating and pain that can radiate to the back.  
• Nausea and vomiting.  
• Weight loss. 
• Feeling full quickly when eating.  

These symptoms are not exclusive to pancreatic cysts and are common to many other abdominal disorders.  

How are pancreatic cysts diagnosed?

Patients with pancreatic cysts are often asymptomatic and they are usually only discovered unintentionally. If a cyst is found, a physical exam followed by further tests will be carried out to determine what type of cyst it is and whether it is cancerous or not. Such tests are: 

• Computerised tomography (CT) scan  
• Magnetic resonance imaging (MRI) scan   
• Endoscopic ultrasound (EUS) 
• Magnetic resonance cholangiopancreatography (MRCP) 

What are the different types of pancreatic cysts?

Most pancreatic cysts are not cancerous. However, some have the potential to become cancerous. Doctors will take a sample of the fluid to determine the type of cyst it. Factors such as the location and characteristics of the cyst as well as the patient’s sex and age can indicate the class of cyst that the patient has.  

As there are almost 20 types of pancreatic cysts, it’s important to determine which one a patient has is order to plan the best treatment and assess the likelihood of cancer developing. Some of the most common types are: 

• Pseudocyst: This is the most common type of cyst that affects the pancreas. It’s benign (non-cancerous) and is caused usually by pancreatitis. Often it can resolve itself.  
• Serous cyst: These are cysts that have a thin fluid inside them and mostly occur in women. Generally, these cysts are low-risk and unlikely to become cancerous.  
• Mucinous cyst: If a cyst is mucinous, it contains a thick and gloopy fluid. For the most part these are also harmless, but they can cause concern because they have the potential to become malignant (cancerous).  

These are broad generalisations used to categorise the types of cysts.  

How are pancreatic cysts treated?  

In most incidences, the best solution is to leave the cyst alone and it will be continuously monitored to ensure it doesn't become malignant (cancerous). However, if the cyst is on the head of the pancreas (the upper part that connects to the small intestine), part of the cyst is solid or if the main pancreatic duct (which carried the pancreatic juices to the small intestine) is large, the patient should be referred for surgery. Surgery is the only treatment and is a major undertaking, given the location of the pancreas. In this case, a team of gastroenterologist and pancreas surgeons will operate on the patient.