Acute pseudocyst

Acute pseudocyst A collection of pancreatic juice enclosed by a wall of fibrous or granulation tissue, which arises as a consequence of acute pancreatitis, pancreatic trauma, or chronic pancreatitis. 

A patient with acute pancreatitis may develop many severe local and systemic complications. Local complications involve fluid collection, necrosis, or abscess in the pancreas. A pancreatic fluid collection (or pancreatic pseudocyst) is a collection of tissue, pancreatic enzymes, and blood that forms weeks after acute pancreatitis. Many pancreatic pseudocysts resolve spontaneously, but some require surgical drainage.5 Rupture of a pancreatic pseudocyst with associated erosion and hemorrhage of major abdominal blood vessels can have a mortality approaching 60% thus, continued monitoring of a pseudocyst is prudent.6... 

Pancreatic abscess is a collection of pus that forms in the pancreas 4 to 6 weeks after acute pancreatitis. Pancreatic abscess is usually less life-threatening than pancreatic necrosis or pancreatic pseudocyst and can be managed with percutaneous drainage.5... 

The goals of treatment for acute pancreatitis include (1) resolution of nausea, vomiting, abdominal pain, and fever (2) ability to tolerate oral intake (3) normalization of serum amylase, lipase, and white blood cell count and (4) resolution of abscess, pseudocyst, or fluid collection as measured by CT scan. 

Local complications in severe AP may include acute fluid collection, pancreatic necrosis, abscess, pseudocyst formation, and pancreatic ascites. 

Severe acute pancreatitis Acute pancreatitis associated with organ failure and/or local complications, such as necrosis, abscess, or pseudocyst. 

Congenital anomalies and aneurysms in the hepatic arteries are very rare. (129) Acquired aneurysms are the result of vessel wall damage, injuries or inflammatory processes. (I3l, 133, 136) Pseudoaneurysms may occur after acute pancreatitis and the formation of pseudocysts. (135) (s. tab. 39.5)... 

There have been over 50 published reports of acute pancreatitis associated with valproate (SEDA-18, 70) (84), including several confirmed by rechallenge. Deaths have occurred from hemorrhagic pancreatic necrosis complications can include pleural and pericardial effusions, coagulopathy, pseudocyst, ascites, wound infection, and pneumonia (SED-13, 151) (85). Hepatotoxicity can coexist. There is suggestive evidence that end-stage renal insufficiency (SEDA-22, 92) and mental retardation (84) can be predisposing factors. 

Local complications—including acute fluid collection, pancreatic necrosis, abscess, and pseudocyst (collection of pancreatic juice and tissue debris enclosed by a wall of fibrous or granulation tissue)— develop about 4 to 6 weeks after the initial attack. Pancreatic abscess is usually a secondary infection of necrotic tissue or pseudocysts and correlates with the severity of the pancreatitis. Most deaths result from... 

Wagholikar GD, Ibrarullah M, Venkataramanapa M (2003) Gastric intramural pseudocyst-a complication of percutaneous drainage of an acute pancreatic pseudocyst. Am J Gastroenterol 98 229-231... 

Because of the retroperitoneal location of the duodenum and its close proximity to the pancreatic head, secondary inflammatory changes with oedema and mural thickening of the duodenal loop may result from adjacent acute pancreatitis (Fig. 9.11). Severe pancreatitis can also cause intramural duodenal hematoma (Abbas et al. 2002), and indeed in this situation thickening of the duodenal wall may lead to symptoms of bowel obstruction. Pancreatic pseudocyst following acute pancreatitis may also cause... 

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