Management
A high index of suspicion must be maintained for the occurrence of a pseudocyst in subjects with a recent history of acute pancreatitis. Confirmation and follow-up is obtained with CT, or more practically, with ultrasound scanning.
Up to 40% of acute pseudocysts will resolve within approximately one week. Supportive treatment is all that is required in this time.
Should the cyst fail to resolve after 2 months, become infected, or is greater than 6cm in diameter, cystogastrostomy or cystojejunostomy is required. The former entails:
- entering the anterior wall of the stomach
- fashioning a large hole through the posterior wall into the pseudocyst
- securing stomach and pseudocyst with a circumferential stitch
The pseudocyst then drains into the stomach.
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