pseudokystes

Pseudocysts, or pseudokystes in some languages, are focal fluid collections surrounded by a non‑epithelial, fibrous wall rather than by an epithelial lining. They are considered false cysts (not true cysts). The most common form is the pancreatic pseudocyst, which develops after an episode of pancreatitis or pancreatic trauma. Pseudocysts may also arise in other sites, including the liver, spleen, and kidneys, but pancreatic involvement is by far the most frequent.

Pathogenesis involves disruption of ductal architecture during pancreatitis, allowing pancreatic secretions to accumulate and be walled off by inflammatory tissue. Over weeks the collection becomes encapsulated; the cyst fluid is typically rich in pancreatic enzymes. True cysts, by contrast, have an epithelial lining.

Clinical presentation ranges from asymptomatic incidental findings to abdominal pain, early satiety, or abdominal mass. Complications include infection, rupture, hemorrhage, obstruction of the gastrointestinal tract or biliary system. Diagnosis relies on imaging such as ultrasound, CT, or MRI; cyst fluid analysis via aspiration can aid differentiation (often elevated amylase in pancreatic pseudocysts).

Management is tailored to symptoms, size, and complications. Many pancreatic pseudocysts resolve spontaneously and are observed. Indications for intervention include persistent symptoms, increasing size, infection, or obstruction. Options include percutaneous drainage, endoscopic internal drainage (such as cystogastrostomy or cystojejunostomy), or surgical drainage. Treating the underlying pancreatitis is important. Antibiotics are used for infected pseudocysts or if rupture occurs.

Prognosis is generally favorable for uncomplicated pancreatic pseudocysts, though complications can worsen outcomes and recurrence can occur. Pseudocysts in other locations are managed according to site, size, and symptoms, with drainage or surgical approaches as appropriate.