Pancreatic cyst - what is it and how to treat?

Cyst of the pancreas is called pathology, accompanied by the formation of abdominal structures in the paine-mathematics layers of the organ.

These tumors contain pancreatic secretion and tissue detritus. In the cavity of the cyst, pancreatic cells gradually die, and in their place fibrous tissues form.

This disease is extremely dangerous, because the tumor can malignant, that is, degenerate into cancer.

Causes of development

PZhZh cyst can develop in any person, regardless of age and gender. In some patients, this disease may be congenital. Along with the cyst PZHZH, they have cystic lesions and other organs:

  • ovaries (in women);
  • the kidneys;
  • brain;
  • the liver.

Most often, PZhZh cyst develops in the background:

  • acute pancreatitis;
  • PZhZh injury;
  • short closure of the excretory duct or disruption of its functioning;
  • helminthiasis - in particular, echinococcosis, cysticercosis;
  • PZhZh tumors.

If we talk about other factors predisposing to this disease, then among them are:

  • alcohol abuse;
  • JCB;
  • obesity;
  • postponed interventions on the gastrointestinal tract;
  • diabetes mellitus (especially type 2).

If a patient has symptoms that even remotely resemble the clinic of PZHZh cysts, it is necessary to study its history in detail. If he has any of the above conditions, the doctor gets every reason to suspect that a patient has a cystic formation in the pancreas.

Classification

According to the generally accepted classification, PJA cyst is:

  1. True (innate). Such a neoplasm is formed before the birth of the child. It does not increase, and its cavity is lined only with cells of the squamous epithelium. True cysts, formed due to obstruction of the PZhZh ducts, provoke inflammatory processes, which, in turn, cause the formation of fibrous tissue ("cystic fibrosis" or polycystic).
  2. False. Such a neoplasm is also called pseudocyst. These cysts appear on the background of inflammatory lesions, injuries or other secondary factors affecting the PZHZH.

Cystic tumors may have different localization. They are able to appear both on the head (15% of cases) and on the body or tail (85%) of the gland. In 90% of the cyst is a secondary disease that developed on the background of pancreatitis. And only in 10% of cases the pathological process occurs after injury.

Cysts that have developed after a person suffered pancreatitis, have their own classification - Atlanta. According to this gradation, they are divided into:

  1. Sharp. Such cysts are formed quickly, do not have a clear structured walls. The cavity of the tumor can be formed from the ducts of the pancreas, its paematological layer or cellulose.
  2. Subacute or chronic. Such cysts develop after the end of the acute phase of the pathology. They are characterized by the formation of cavity walls, consisting of granulomatous or fibrous tissues.
  3. Abscesses In this pathological process, the cystic cavity contains purulent exudate. This is a very dangerous form of the disease that requires immediate medical intervention.

According to the nature of the disease, PZhZh cysts are divided into complicated and uncomplicated.

Symptoms

Clinical manifestations of cysts and treatment are directly dependent on the size, number and location of the tumor. With small cysts, the patient does not show any complaints, so they are rarely diagnosed.

But when the cyst grows and reaches a large size, it begins to put pressure on the adjacent tissues and organs. As a result, patients begin to complain of symptoms in the form of:

  1. Pain of different localization and intensity. They can appear periodically, that is, be paroxysmal in nature (as in pancreatitis), or they can be present all the time, but be less pronounced. Especially often the source of pain is located in the pit of the stomach, in the hypochondrium. Sometimes the pain may radiate to the back.
  2. Education bulges in the upper abdomen. This symptom is observed with rather large sizes of PJA cysts.
  3. Dyspeptic disorders characteristic of pancreatic insufficiency. Diarrhea, flatulence, bloating - all these signs may indicate a cyst PZHZH. In addition, most patients lose weight dramatically, and they also note the presence of undigested food particles in the feces.
  4. Discoloration of feces occurring against the background of darkening of the urine, which acquires a hint of dark beer.
  5. Mechanical jaundice. The symptom is accompanied by severe itching in the body, and is a consequence of the compression of the biliary tract increased cyst.
  6. Dyspeptic disorders - nausea, loss of appetite, vomiting (when squeezed by the duodenum cyst).

Large cysts PZHZH are not harmless tumors. When squeezing adjacent organs, it can lead to:

  • suppuration or abscessing (manifested by fever);
  • rupture of cysts;
  • bleeding;
  • fistula formation.

Complications

The pancreatic cyst is very dangerous, as it can be reborn as a cancer. Cystic cavities themselves can be formed from benign or malignant cells.

Cancer PZhZH - very dangerous and serious condition. It is almost impossible to cure it, since it is accompanied by rapid and extensive metastasis to other organs.

But benign cysts are no less dangerous because of their tendency to rupture. The consequence of this often becomes extensive peritonitis, including purulent.

Another complication of cyst PZHZH is the formation of fistulas. Such a condition is extremely dangerous due to the high risk of the accession of a secondary infection with all the ensuing consequences.

Large-sized cysts squeeze tissue and blood vessels of the gland and other organs of the abdominal cavity, causing complications in the form of:

  • development of obstructive jaundice (if the tumor is located in the head of the pancreas fluid);
  • swelling of the lower extremities (pi pressure cysts on the portal vein);
  • dysuria and other disorders of the functioning of the MFU (when putting pressure on this system).

Rarely occurs intestinal obstruction. Such a deviation is observed in patients with large pancreatic cysts covering the lumen in the intestinal loops.

Diagnostics

For the detection of cystic neoplasm in the tissues of the pancreas, a special role is given to ultrasound. With its help, the state of the pancreas itself, as well as of neighboring organs and adjacent tissues, is assessed.

For a more detailed visualization and full assessment of the functioning of the patient's body, the following diagnostic measures are carried out:

  • CT scan;
  • angiography;
  • magnetic resonance therapy;
  • splenoportography;
  • diagnostic laparoscopy or laparotomy;
  • hematocrit and hemoglobin blood tests to detect hidden bleeding.

On the basis of the obtained data, an accurate diagnosis is made, and an effective therapeutic tactic is developed in a particular case.

How to treat a cyst?

The choice of the method of treating a disease directly depends on the size of the neoplasm, its connection with the bile duct and the presence of associated complications. Conservative therapy is effective only with small sizes of cysts and the presence of inflammatory processes in the tissues of the gland.

Surgical removal of cysts can be performed by:

  • open operation;
  • percutaneous puncture access;
  • video endoscopic surgery.

For small cysts, the decision is made on the use of observational tactics. In this case, the patient must regularly undergo diagnostic procedures to record the progression of the pathological process. If the cyst enlarges, or consists of malignant cells, emergency measures are taken to remove it.

Drug therapy

Drug treatment is prescribed for small pancreatic cysts. Used mainly spasmolytic and analgesic drugs. Concurrently prescribed means that remove toxins from the body. Selection of medications depends on the symptoms of the pathology. Because of this, doctors may resort to the appointment:

  1. Antiemetics: Cerucal, Motilium, etc.
  2. Antispasmodics: Papaverine, Drotaverina, No-Shpy.
  3. Carminatives: Espumizana, Herbion, etc.
  4. Anesthetic medicines: Baralgin, Pentalgin, Analgin and others.
  5. Enzyme Drugs: Pancreatin, Festal, Mezim, Creon.

In severe cases of the disease, antimicrobial and antipyretic drugs may be necessary.

During the entire course of treatment, the patient must follow a diet with the exception of harmful food. Instead, foods rich in plant fiber should be added to the diet, as they contribute to normal digestion.

Operations

To remove a PZH cyst, surgery can be performed in several ways, as described below.

Laparoscopy

Laparoscopy is a minimally invasive method for the surgical treatment of PJA cysts. It is resorted to, as a rule, with single cystic neoplasms. The contents of the cyst is punctured and sucked with a special puncture needle.

Cystoenterostomy

During this surgical procedure, the cyst is opened and treated with antibacterial solutions. After that, the walls of the emptied capsule are stitched in such a way that a duct is formed for the withdrawal of gastric juice in the gastrointestinal tract.

Resection, or open surgery

During resection, the cyst contents are removed along with part of the diseased organ. This is a serious operation, carried out according to strict indications with the ineffectiveness of other medical, including surgical, techniques.

Sclerosing cyst

Sclerotherapy involves the introduction of special alcoholic solutions cyst, due to which it is eliminated.

The specific surgical procedure is chosen by the doctor individually for each patient. After the intervention, the patient should periodically undergo a prophylactic ultrasound scan to eliminate the risk of recurrence of the pathology.

Nutrition

Of great importance is nutrition during a diagnosed PJV cyst. Diet requires mandatory exclusion from the diet:

  • alcohol;
  • spices;
  • spicy dishes;
  • strong broth of any composition;
  • beans, peas, beans, because they contribute to the formation of gases, thereby causing bloating and flatulence;
  • fatty and carbohydrate foods, because the body, deprived of the required amount of enzymes, simply can not properly digest it;
  • late apple varieties;
  • pears;
  • radish and radish;
  • all varieties of cabbage.

Instead, it is recommended to enter the daily menu:

  • fresh milk;
  • low-fat sour cream and cottage cheese;
  • natural butter;
  • fermented milk products with a low percentage of fat;
  • mild hard cheeses;
  • different types of cereals (cereal and semolina porridge can be used infrequently);
  • omelets;
  • boiled eggs;
  • homemade croutons;
  • toasts;
  • dried bread;
  • fish and fish products;
  • bird (but not semi-finished products, and only without skin);
  • lean meats - veal, beef, lamb;
  • citrus fruit;
  • vegetables, heat treated - baked, stewed, boiled, steamed;
  • fresh greens (in moderation).

If you follow all the recommendations regarding nutrition during the remission phase of a pancreatic cyst, the disease may not remind you of yourself for a long time. The balance of the daily diet contributes to a well-coordinated digestion, and this, in turn, eliminates the need for surgical intervention.

Prevention

Prevention of pancreatic cyst is the proper, balanced diet, and maintaining a healthy lifestyle. In addition, it is necessary regularly, once every 6 - 12 months, to undergo a detailed medical examination, laboratory and instrumental diagnostics. And when the first warning symptoms appear, do not self-medicate, but seek medical help immediately.

Forecast

The prognosis of a cyst PZHZH mostly favorable. After completing the course of therapy, a person can return to his previous activities and hobbies, and lead his usual lifestyle. However, from time to time you should give the body a rest, and make certain adjustments to the diet. And bad habits must be completely and completely abandoned.

If a patient with a cyst PZHZH turned for medical help out of time, then the prognosis worsens significantly. In this case, a large cyst either squeezes the adjacent organs and tissues, or begins to malignantly, that is, degenerate into a cancerous tumor. In this case, it will be much more difficult to get rid of the disease. The patient will need a serious and long-lasting treatment, which, however, cannot guarantee complete recovery, even if it was performed surgically.

Watch the video: What You Need to Know About Pancreatic Cysts (October 2019).

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