Small (less than two cm) cysts usually cause no symptoms. Large pancreatic cysts can cause abdominal pain and back pain presumably by exerting pressure on the surrounding tissues and nerves.
Small or large cysts in the head of the pancreas also may cause jaundice (yellowing of the skin and eyes with darkening of urine color) due to obstruction of the common bile duct.
If the cysts become infected, it may result in fever, chills, and sepsis.
On rare occasions, large pseudocysts can compress the stomach or the duodenum leading to obstruction in the movement of food in the intestines, resulting in abdominal pain and vomiting.
If a cyst becomes malignant and begins to invade the surrounding tissues, it may lead to the same type of pain as pancreatic cancer, pain that usually is constant and felt in the back and upper abdomen.
Pancreatic pseudocysts need treatment if they persist beyond six weeks after acute pancreatitis, especially if they reach a large size and cause symptoms such as obstruction of the stomach or common bile duct, abdominal pain, or become infected. These patients are monitored with yearly scans (for example, yearly ultrasound or MRI).
Pancreatic cysts larger than 2 cm in young, healthy individuals usually are treated with surgical removal, especially if the cysts produce symptoms.
Pancreatic cysts larger than 2 cm in elderly patients can be studied with endoscopic ultrasound and fine needle aspiration. If fluid cytology,, CEA measurements or analysis of DNA suggest cancerous or precancerous changes, the patients can be evaluated for pancreatic surgery.