Management of pancreatic pseudocysts in relation to pain relief

Seventy patients were treated either surgically, by percutaneous puncture, or conservatively for pancreatic pseudocysts at this hospital; 61 (87%) had pain, which in most cases was moderate. Before admission 14 patients had been taking opioid drugs regularly and 18 had used opioids occasionally. Nine patients used non-opioid analgesic drugs less than once a day. Pain relief after treatment was less effective in patients for whom pain was the main symptom. The patients in whom pseudocysts were a complication of chronic alcoholic pancreatitis had more severe pain than those whose pseudocysts followed trauma or attacks of acute pancreatitis. There was a positive correlation between the degree of pain and the size of the pseudocyst in patients with acute pancreatitis, but there was no correlation between the degree of pain and the presence of bacteria in the cyst fluid (n = 8). Pseudocysts in the tail of the pancreas caused less pain than those in the head.