Kurt - Pseudocyst Information

[Guest guest]

Dear Kurt,

I found a bunch of information that I think you will be interested in. But I

just wanted

to cut and paste some that I read from the text-book " on's Online " .

The first quote that I found interesting may be relevant to your " hiatal

hernia " . See if

this could fit your situation...it is a statement about what the clinician may

find on a

physical exam on someone with a pseudocyst: " A palpable, tender mass may be

found in the middle or left upper abdomen. "

And the rest that I am pasteing into this post deals with some general

information

concerning when to treat a p-cyst. I have many, many documents that I found for

you

too. Some from the GI / Endoscopist point of view....some from the surgeons

point of

view....all addressing when to treat and how to treat....the various drainage

procedures, etc.

Here is the second quote that I wanted you to see (hope this is the type of info

that

you are looking for):

" A pseudocyst that does not resolve spontaneously may lead to serious

complications, such as (1) pain caused by expansion of the lesion and pressure

on

other viscera, (2) rupture, (3) hemorrhage, and (4) abscess. Rupture of a

pancreatic

pseudocyst is a particularly serious complication. Shock almost always

supervenes,

and mortality rates range from 14% if the rupture is not associated with

hemorrhage

to over 60% if hemorrhage has occurred. Rupture and hemorrhage are the prime

causes of death from pancreatic pseudocyst. A triad of findings—an increase in

the

size of the mass, a localized bruit over the mass, and a sudden decrease in

hemoglobin level and hematocrit without obvious external blood loss—should alert

one to the possibility of hemorrhage from a pseudocyst. Thus, in patients who

are

stable and free of complications and in whom serial ultrasound studies show that

the

pseudocyst is shrinking, conservative therapy is indicated. Conversely, if the

pseudocyst is expanding and is complicated by rupture, hemorrhage, or abscess,

the patient should be operated on. With ultrasound or CT guidance, sterile

chronic

pseudocysts can be treated safely with single or repeated needle aspiration or

more

prolonged catheter drainage with a success rate of 45 to 75%. The success rate

of

these techniques for infected pseudocysts is considerably less (40 to 50%).

Patients

who do not respond to drainage require surgical therapy for internal or external

drainage of the cyst. "