Which of the following is not a complication of pseudopancreatic cyst: March 2005

Ans. A: Malignancy Pseudocysts of the pancreas are collections of pancreatic juice surrounded by a wall of fibrous tissue that is not lined by epithelium. Pseudocysts are connected with the pancreatic duct system either as a direct communication or indirectly the pancreatic parenchyma. They are caused by pancreatic ductal disruption following increased pancreatic ductal pressure either due to stenosis, calculi or protein plugs obstructing the main pancreatic ductal system or as a result of pancreatic necrosis following an attack of acute pancreatitis. Complications of pseudocysts in chronic pancreatitis are: Rupture into the gastrointestinal tract either results in no symptoms or leads to melaena or haematemesis that usually requires urgent conservative measures. Rupture into the general peritoneal cavity results in features of peritonitis and on occasions an associated haemorrhagic shock. Haemorrhage can greatly complicate the course of a pseudocyst. Interventional radiology can play an invaluable role both in locating the source of bleeding and in embolisation of the bleeding vessel. Infection occurs either spontaneously or after therapeutic or diagnostic manipulations. Biliary complications occur due to a large cyst in the pancreatic head region obstructing the common bile duct and resulting in obstructive jaundice. Poal hypeension can result from compression or obstruction of the splenic vein/ poal vein either by the cyst alone or in conjunction with underlying chronic pancreatitis.