Pancreatic pseudocysts are the most common cystic lesions of the pancreas, accounting for 75-80% of such masses. A pancreatic pseudocyst is a collection of amylase-rich, lipase-rich, and enterokinase-rich fluid. It is most frequently located in the lesser peritoneal sac in proximity to the pancreas. Large pseudocysts can extend into the paracolic gutters, the pelvis, the mediastinum, and, rarely, the neck or scrotum.
Some pseudocysts in the pancreatic parenchyma are loculated. The most common etiologies for pancreatic pseudocysts include chronic pancreatitis, acute pancreatitis, and pancreatic trauma. In addition, pseudocysts are associated with pancreatic ductal obstruction and pancreatic neoplasms.
Pseudocystic fluid has electrolyte concentrations similar to those in plasma. In addition, however, pseudocystic fluid has a high concentration of amylase, lipase, and enterokinases (such as trypsin). These concentrations reflect the origin of the lesion from extravasated pancreatic exocrine secretions resulting from pancreatic ductal disruption. The pancreatic secretions incite an intense inflammatory response, which eventually leads to the development of a thick, fibrous capsule surrounding the pancreatic fluid.
Source: MedScape /Pancreatic Pseudocyst Imaging
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