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Diagnosis of pancreatic cysts
Last reviewed: 03.07.2025
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Laboratory tests are of little use in diagnosing pancreatic cysts and, at best, reveal signs of chronic pancreatitis: disturbances in the exocrine and endocrine functions of the pancreas.
The main methods of detecting pancreatic cysts are ultrasound and CT (unfortunately, as a relatively new diagnostic method, it is not yet available in all hospitals in the country). In some cases, as noted above, displacement of an organ from its usual position, usually located in the epigastric region or left upper quadrant of the abdomen, may cause the radiologist to assume that the patient may have a tumor or cyst of the pancreas. In addition, plain radiography can sometimes detect areas of calcification or individual small foci of calcium salt deposition in the area of former necrosis after acute pancreatitis or another exacerbation of chronic recurrent pancreatitis; areas of calcification are sometimes found in the wall of the resulting cysts. Such research methods as tomography during pneumoperitoneum, scanning for detecting pancreatic cysts are almost never used at present. ERCP for pancreatic cysts, especially after inflammatory and traumatic ones, is unsafe, since the introduction of contrast into the ducts of the gland in the direction opposite to the flow of pancreatic juice can cause an exacerbation of pancreatitis. However, this method, performed by an experienced specialist, and with special indications, allows you to establish a connection between the cyst and the pancreatic duct. Angiography for detecting pancreatic cysts is currently rarely used, but in particularly difficult to diagnose cases, it sometimes allows you to clarify the nature of focal changes in the pancreas and confirm the presence of cysts.
[ Differential diagnosis of pancreatic cysts
Differential diagnostics are carried out between pancreatic cysts and tumors and cysts of nearby organs, omentum, retroperitoneal or interloop intestinal abscess, tumors and cysts of the mesentery of the transverse colon.
Secondary differential diagnostics of pancreatic cysts consists in establishing the nature of cysts in each specific case, since with their etiological diversity, cysts of different origins are essentially only an "external", most easily detected (especially with the help of modern instrumental diagnostic methods) manifestation of a number of completely different diseases. However, the peculiarities of symptoms, anamnesis (pancreatitis attacks in the past, abdominal trauma, especially in the epigastric region and the left hypochondrium) in some cases, some still not entirely clear elements of hereditary transmission of pancreatic diseases, including cysts, the presence or absence of polycystic disease of other organs, echinococcosis to a certain extent help to distinguish cysts of different origins. It is also necessary to take into account the comparative frequency of cyst occurrence: the most frequent (tens of times) are cysts that arise as a result of severe pancreatitis with foci of pancreatic necrosis, post-traumatic cysts, i.e. pseudocysts, are somewhat less common. Finally, modern instrumental research methods - ultrasound, CT, etc. - allow in some cases to differentiate pancreatic cysts of various origins even more accurately.