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Acute pancreatic pseudocysts: incidence and implications

E L Bradley, A C Gonzalez, J L Clements

    Annals of Surgery
    |December 1, 1976
    PubMed
    Summary

    Acute pancreatitis can lead to fluid collections called pseudocysts. While many acute pseudocysts resolve spontaneously, about half progress to chronic forms requiring different management.

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    Area of Science:

    • Gastroenterology
    • Radiology
    • Surgical Pathology

    Background:

    • Acute pancreatitis is a common condition with potential complications.
    • Fluid collections, including pseudocysts, can develop in the early stages of acute pancreatitis.
    • Distinguishing between acute and chronic pseudocysts is crucial for appropriate treatment.

    Purpose of the Study:

    • To evaluate the incidence and natural history of acute pseudocysts in patients with moderately severe acute pancreatitis.
    • To assess the role of ultrasonography in diagnosing and monitoring pseudocysts.
    • To determine the rate of spontaneous resolution versus progression to chronic pseudocysts.

    Main Methods:

    • Prospective study of 92 patients with moderately severe acute pancreatitis within three weeks of onset.
    • Ultrasonic tomography (ultrasound) used for initial assessment and serial follow-up.
    • Surgical or autopsy confirmation for pseudocyst diagnosis in a subset of patients.

    Main Results:

    • 52 out of 92 patients developed acute fluid collections (pseudocysts).
    • Ultrasound prediction was confirmed in 26 cases; 10 acute pseudocysts resolved spontaneously.
    • 3 false positive ultrasound predictions were noted; 11 patients were lost to follow-up or refused surgery.

    Conclusions:

    • Acute pseudocyst formation is common in moderately severe acute pancreatitis.
    • Spontaneous resolution occurs frequently, but approximately 50% progress to chronic pseudocysts.
    • Serial ultrasonography is recommended for acute pseudocysts under three weeks, while chronic pseudocysts rarely resolve spontaneously and may require intervention.

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