Pancreatic Pseudocyst

• Contrast CT or MRI/MRCP of the abdomen showing the size, wall thickness, position and any connection to the pancreatic duct.
• Endoscopic ultrasound report, if done, including any fluid analysis that separates a pseudocyst from a cystic tumour.
• Blood tests usually requested: amylase, lipase, full blood count, liver function and inflammatory markers.
• Discharge summary from the original pancreatitis admission, including the cause (gallstones, alcohol, other) and any infection or intensive care.
• Serial imaging showing whether the collection has grown, shrunk or stayed the same over time.

1. Is this a true pseudocyst or walled-off necrosis, and how did you tell the two apart on imaging?
2. Does the collection need drainage now, or is watching with repeat scans reasonable?
3. If drainage is advised, would it be endoscopic, percutaneous or surgical, and why that route for me?
4. What was the underlying cause of my pancreatitis, and how do we prevent another attack?
5. How likely is the fluid to come back, and what symptoms should send me for urgent review?
6. What follow-up scans will I need after the procedure, and for how long?

Many pseudocysts shrink without treatment, particularly small ones without symptoms. Those that persist, enlarge or cause pain, vomiting, jaundice or infection are usually drained, and endoscopic drainage works well in most suitable patients. Outlook depends on the size and maturity of the wall, whether there is dead tissue inside, and the cause of the pancreatitis. Ongoing alcohol use or untreated gallstones raise the chance of recurrence.