Pancreatic cysts

Overview

Pancreatic cysts are fluid-filled sacs that form on or inside the pancreas, a gland behind the stomach that helps with digestion and blood sugar control. Most pancreatic cysts are not cancer (benign), but some can become cancerous over time. Because they often cause no symptoms, many are discovered by chance during scans for other reasons.

Pancreatic cysts are becoming more common as imaging technology improves. They are found in about 2% to 15% of people who have scans of the abdomen, especially in older adults.

Pancreatic cysts can occur at any age, but they are more common in people over 40. Some types are more frequent in women, and others are linked to certain genetic conditions.

Symptoms

Common symptoms

• Most pancreatic cysts cause no symptoms at all.
• If symptoms occur, they may include a dull ache or pain in the upper abdomen or back.
• Some people experience nausea, vomiting, or a feeling of fullness after eating small amounts.

Symptoms in children

• Pancreatic cysts are rare in children. When they do occur, symptoms may include abdominal pain, a lump in the belly, or jaundice (yellowing of the skin or eyes).

Symptoms in older adults

• Older adults are more likely to have pancreatic cysts. Symptoms are similar to adults but may be harder to notice because of other health conditions.

Causes

Main causes

• Pancreatic cysts can form due to inflammation of the pancreas (pancreatitis), injury, or genetic conditions.
• Some cysts are linked to a condition called intraductal papillary mucinous neoplasm (IPMN), which is a growth in the pancreatic ducts.
• Other cysts, like serous cystadenomas, have no clear cause and are usually benign.

Risk factors

• Age over 40.
• Chronic pancreatitis (long-term inflammation of the pancreas).
• Family history of pancreatic cysts or pancreatic cancer.
• Certain genetic syndromes, such as von Hippel-Lindau disease or Peutz-Jeghers syndrome.

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe abdominal pain or jaundice, seek emergency care immediately.
• If you have a high fever with abdominal pain, see a doctor the same day.

Book a routine appointment if:

• If you have any ongoing abdominal pain, bloating, or digestive changes, make an appointment with your doctor.
• If you have been told you have a pancreatic cyst, follow up as recommended for monitoring.

Diagnosis

Pancreatic cysts are usually discovered during imaging tests done for other reasons, such as a CT scan, MRI, or ultrasound. Once found, doctors use additional tests to learn more about the cyst's type and risk.

Tests that may be done

• CT scan (computed tomography) – detailed images of the pancreas.
• MRI (magnetic resonance imaging) with MRCP – special images of the pancreatic ducts.
• Endoscopic ultrasound – a thin tube with a camera and ultrasound probe is passed through the mouth into the stomach to get a closer look.
• Fine needle aspiration – a thin needle is used to remove fluid from the cyst for analysis.

What to expect at your appointment

Your doctor will review your medical history and symptoms. You may need several imaging tests over time to watch for changes. In some cases, a sample of the cyst fluid will be taken to check for cancer cells. Your healthcare team will explain each step and what the results mean.

Treatment

Treatment depends on the type, size, and risk of the cyst. Many cysts are simply watched with regular scans. If a cyst is large, causing symptoms, or has features that suggest cancer, doctors may recommend removing it with surgery.

Self-care at home

• Report any new or worsening symptoms to your doctor promptly.
• Keep all follow-up appointments for imaging tests.
• Maintain a healthy lifestyle with a balanced diet and regular exercise.

Medical treatments

If a cyst is causing symptoms or has concerning features, your doctor may recommend endoscopic drainage (using a scope to drain the cyst) or surgical removal. These procedures are done by specialists. No specific medications are known to shrink pancreatic cysts.

When is surgery considered?

Surgery may be needed if the cyst is large, causing pain or blockage, or if it has a high risk of becoming cancer. The type of surgery depends on the cyst location and size. Your surgeon will discuss the risks and benefits with you.

Living with this condition

Most people with pancreatic cysts live normally without any daily changes. If your cyst is being monitored, you will have regular scans to check for changes. Living with a known cyst can sometimes cause anxiety, but most are harmless.

Lifestyle tips

• Stay active and eat a balanced diet low in processed foods.
• Avoid smoking and limit alcohol, as these can harm the pancreas.
• Manage stress with relaxation techniques like deep breathing or gentle exercise.

Diet and exercise

No special diet is needed for most cysts. Eating smaller, more frequent meals may help if you feel full quickly. Regular exercise, like walking or swimming, supports overall health.

Mental health and emotional wellbeing

Being told you have a pancreatic cyst can be worrying, especially because of the link to cancer. It is normal to feel anxious. Talk to your doctor about your concerns and consider speaking with a counsellor or support group.

Prevention

There is no known way to prevent most pancreatic cysts. However, avoiding smoking, limiting alcohol, and maintaining a healthy weight may reduce your risk of pancreatic problems.

Vaccines

Omit

Screening programmes

Screening for pancreatic cysts is not recommended for the general public. If you have a strong family history of pancreatic cancer or certain genetic syndromes, your doctor may suggest regular imaging tests.

Complications

If left untreated

• A cyst could grow and press on nearby organs, causing pain or jaundice.
• Some cysts can become infected, leading to fever and severe illness.
• Certain types of cysts can develop into pancreatic cancer if not monitored or treated.

Long-term outlook

The outlook for most people with pancreatic cysts is excellent. With proper monitoring and treatment when needed, serious problems can be avoided. Even when surgery is required, many people recover well and return to their normal lives. Your healthcare team will guide you every step of the way.

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