Epidemiology

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Etiology

• Chronic heavy alcohol use (most common, esp. men)
• Pancreatic ductal obstruction
• Tobacco use
• Idiopathic pancreatitis
• Hereditary pancreatitis
  • PRSS1 gene mutation
  • Age of onset < 20 years
  • Characterized by a positive family history and the absence of other risk factors
• Systemic disease
  • Cystic fibrosis
  • Severe hypertriglyceridemia (levels > 1,000 mg/dL)

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Pathophysiology

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Clinical features

Complications

Pancreatic pseudocysts

Definition

• Encapsulated collection of pancreatic fluid that develops 4 weeks after an acute attack of pancreatitis (can occur in both acute and chronic pancreatitis)

Pathophysiology

• Pancreatic secretions leak from damaged ducts → inflammatory reaction of surrounding tissue → encapsulation of secretions by granulation tissue

Clinical features

• Often asymptomatic
• Painless abdominal mass
• Pressure effects
  • Gastric outlet obstruction (early satiety, nonbilious vomiting, abdominal pain)
  • Obstruction of the distal duodenum (bilious vomiting) may result in steatorrhea.
  • Bile duct obstruction with jaundice

Diagnostics

• First line: CT abdomen with contrast
  • Findings: Extrapancreatic fluid collection within well-defined wall or capsule with contrast enhancementA large circumscribed fluid collection (green overlay) with an enhancing wall (red overlay) surrounds the pancreas (P).

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Diagnostics

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Treatment

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