Pancreatic cysts: causes, treatment and diet

Pancreatic cyst (CSW) is a encysted formation of connective tissue with liquid contents, located close to the gland tissues. This rarely occurring pathology of the pancreas (pancreatic), as a rule, is the result of inflammatory or traumatic parenchymal organ. In addition, the cyst may have a parasitic origin.

Symptomatology CSW depends on the amount of accumulated liquid, compromising its function and the degree of compression of cyst adjacent organs. Displacement cystic very bags is variable and depends on the etiology of limitation formation and presence of aggravating factors. Cyst can contain from 50 ml to 8.7 liters of fluid and go far beyond the body.

Aggravating factors

Pancreatic cysts can occur in people of all ages. Cystic capsules may be of various sizes and quantities. Possible systemic polycystic when attacked not only the pancreas, and ovaries, brain, liver and / or kidneys. It is characterized by congenital abnormalities. Lzhekista occurs against a background of another illness.

Causes:

• short clogging biliary duct stones (cholelithiasis);
• acute pancreatitis;
• injury to the pancreas;
• Parasitic diseases caused by helminths - cysticercosis, hydatid disease;
• tumor process in the pancreas;
• clamping the vessel zhelcheprovodyaschego channel;
• motor dysfunction of the pancreas;
• diabetes mellitus of second type.

The reasons may be due to the influence of adverse external factors, such as:

• alcohol abuse;
• obesity caused by lipid metabolism disorders;
• prior surgeries on any organ gastrointestinal tract.

Classification

There are two main categories that classify all cysts forming on the pancreas. In the first form of classification, cysts are distinguished by their structure. Thus, there is:

• true pancreatic cyst (a congenital pathologies having glandular epithelial layer);
• Pancreatic pseudocyst (formed after disease).

Also abdominal education are classified according to the place of their location on the body. Consequently, there are three places of localization:

• cyst of the pancreas tail (this education does not hurt the surrounding pancreas organs);
• cyst pancreas head (formation which occurs less frequently other, and can pinch the duodenum);
• cyst in the pancreatic body (found most often violates a provision of the stomach and colon) /

By the nature of education are distinguished:

• benign;
• malignant;
• precancerous.

In size, cysts are - small and large. Small often have a size up to 20 millimeters long can reach ten centimeters in volume.

symptoms

A cyst in the pancreas undergoes several stages of formation:

• Primary education is the inclusion of the cavity, most commonly it occurs after 1-1.5 months after pancreatitis.
• After 2-3 months there is a capsule wall but it is still too loose and vulnerable.
• About six months later the tumor ends its formation and now has a thick wall.
• After 6-12 months capsule with liquid separated from the surrounding tissue and becomes independent switching, able to shift from its original location.

Painting disease depends on the size of the formation. So, in a small package the patient can not feel discomfort, but only accidentally discovered a cyst on ultrasound. For the following symptoms occur with the growth of cystic formation:

• weight loss, weakness, fever periods;
• nausea, vomiting, unstable chair;
• transient pain in the pit of the stomach or back, with time increasing from attack to attack, especially strong, if the cyst is localized in the solar plexus;
• cyst may displace adjacent organs (stomach, intestines, liver) and disturb their work;
• cyst size at sufficient it starts palpable through the abdominal wall to form a smooth rounded, usually painless formation;
• rapid change in the nature of pain and the formation of the size, a sharp jump in temperature may indicate the development of complications of pancreatic cysts;
• if there is compression of the bile duct cyst in the head of the gland, jaundice appears.

diagnosis of cysts

An ultrasound can diagnose pancreatic cyst all departments - head, body and tail. Endoscopic ultrasonography further allows to determine the formation of benign or malignant.

Diagnostic methods are quite diverse. On plain film abdomen can be determined shadow, the position of which corresponds to the brush border. If this study found deformed boundaries of the stomach, it is also suspected cyst.

Duodenography with high confidence reveals cysts contours. When barium enema can detect large sinking downward cysts, polycystic pancreas at angiorgafii celiac artery branches are clearly visible contours cysts of any size.

How to treat a cyst?

pancreatic cyst treatment therapies conducted if:

• pathological focus is clearly limited;
• It has a small volume and size (up to 2 cm in diameter);
• Education is only one;
• no symptoms of jaundice and severe pain syndrome.

In all other cases resort to surgical methods of treatment.

For the first 2-3 days appointed starvation diet. In the subsequent need to limit the intake of fatty, fried and salty foods, since it stimulates the secretion of pancreatic enzymes and enhances tissue destruction (see. that you can eat with chronic pancreatitis). Alcohol and smoking should also be excluded. patient mode - bed (7-10 days).

Assigned antimicrobials tetracycline or cephalosporins, are aimed at preventing ingress of bacterial infection in the cysts and the cavity being filled with pus. Otherwise, possibly melting of the walls and the rapid spread process on the prostate and adjacent tissues.

To reduce pain and can reduce the secretion of assigning "proton pump inhibitors" (OMEZ, omeprazole, rabeprazole, and so on). For normal digestion of carbohydrates and fats shows various compounds enzyme therapy - drugs, which is composed of amylase and lipase, but no bile acids (Pancreatin, Creon).

surgical methods

If conservative treatment is ineffective for 4 weeks, it is shown surgery. Modern medicine involves removal of cysts using minimally invasive techniques. Nevertheless, 92% of patients have to be at the time of treatment in a hospital. Variants of the operation, there are about seven.

If an intervention is carried out under the control of ultrasound, it significantly reduces the risk of possible complications. They are shown at the location of the formation in the body area of ​​the body or in his head, because in these cases, give the best effect. To perform the procedure, the patient make a puncture in the epigastric region, is introduced through the puncture needle (as an option - aspirator) followed by cyst removed.

Manipulation surgeon depends on the size of education:

1. Percutaneous puncture drainage cysts - after performing purification of cyst cavity formation in the liquid Drainage set (rubber tube), which provides a constant outflow of liquid from the Pathological education. Drainage is not extracted until no release of fluid. These manipulations are necessary for self-closure of the defect (overgrowth of connective tissue). Such an operation is not performed if the cyst has a large volume (over 50-100 ml) or overlaps the duct cancer.
2. Hardening of the formation based on the introduction of a solution having a specific chemical activity. He entered after draining the cyst. Further there is a natural process of proliferation of connective tissue and the defect is eliminated.

If you perform percutaneous manipulations impossible, it is necessary to go to the version of laparoscopic surgery. It provides for the implementation of the two sections is not more than 2 cm in length, through which the abdominal cavity and introduced endoscopic instruments. Such operations are characterized by a large number of possible complications, even in spite of its minimally invasive. These include:

1. Excision and occlusion formation. Perform this operation possible, when the brush is located superficially. During surgeon exposes its procedures sanitizes using antiseptic solutions and sutured tightly. Perhaps the use of electrocautery instead of a needle, but in this case the need to install drainage pipes up to a week.
2. Laparoscopic resection, which is performed in the presence of pronounced defect in body tissues. For example, if breast cyst head has a size of 50-70 mm, it requires the removal of the head. Although this operation is traumatic enough, the risk of recurrence is minimized.
3. Operation Frey (removal of glands of the head with the creation pankreatoeyunalnogo anastomosis) - is one of surgical modifications discussed above. It requires the presence of a strong expansion of the gland ducts. Technique of this kind of operation consists in sewing gland duct to the small intestine directly. This makes it possible to normalize the process of separation of enzymes and to minimize the likelihood of developing pancreatic necrosis.

Laparotomy operation is the last one to which surgeons have resorted. For its implementation is necessary to open the abdomen. In this case, the patient will have to undergo a lengthy recovery period.

Laparotomy can be performed according to the principle:

1. Open resection;
2. According to the principle of excision of education and its further drainage;
3. Marsupilizatsiya cysts - this operation was first carried out in the seventies and today it has not lost its relevance. Her technique is very original and is to unpack and cysts rehabilitation, after which the wall sutured to the edge of the cut. Next, spend the entire layer by layer suturing wounds. The main drawback of this method is the frequent formation of sinus tracts.

Cyst of the pancreas is a rare pathology and in the world is found in no more than 0, 006% of the population (according to Professor Vladimir Vinogradov AT.). However, it significantly reduces the quality of life of the patient, so it is important to its timely detection and removal.

Nowadays, modern medicine is able to cope with this disease without any difficulties. The only condition to ensure a positive outcome of the treatment of pancreatic cyst is a timely appeal for the qualified help.

correction power

Any abnormality of the pancreas involves dieting. In the presence of a cyst, you may need to adhere to for a long time. In cases where there is chronic diseases, assigned diet for life.

Forbidden to eat:

• fried, smoked, spicy;
• pickled products;
• alcohol;
• meat products;
• fat, fat;
• sweet cream (pastries, cakes);
• fresh bakery products;
• sauces, mayonnaise;
• seasonings.

Patients should be used:

• cereals (buckwheat, rice, oats, semolina);
• fish is not fat varieties;
• milk and milk products with reduced fat content;
• eggs (preferably a protein);
• boiled and roasted poultry, rabbit and beef (not fat);
• soups on water.

Beyond the acute phase can be eaten boiled pork, pearl barley. Other products should be discussed with your doctor, who will adjust the menu if necessary.