Intrapancreatic cysts associated with relapsing pancreatitis

Intrapancreatic cysts were demonstrated by endoscopic retrograde pancreatography (E.R.P.) in nine patients with a clinical diagnosis of relapsing pancreatitis. The cysts ranged in diameter from 0.6 cm to 5 cm and were frequently associated with a prolonged elevation of the serum amylase level. The complication of intracystic haemorrhage with obstructive jaundice developed in one patient requiring early surgical decompression and drainage. In four patients laparotomy was performed because of continuing abdominal pain. One patient was treated by cystogastrostomy and another by cyst aspiration, but in two patients the cyst could not be visualized or palpated. Four patients were observed without operation for periods of four to 24 months, and all showed improvement or resolution of symptoms. E.R.P. was repeated in one patient and the cyst could not be outlined, while in another an abnormal barium meal X-ray examination result reverted to normal. Intrapancreatic cysts can be managed non-operatively, since complications appear infrequent and spontaneous resolution may occur.