Pancreatic pseudocysts during first attack of acute pancreatitis.

One hundred and forty-eight patients admitted with their first episode of acute pancreatitis were examined by ultrasonography. During the acute attack 1 or more pseudocysts were found in 19 patients (13%), pancreatic abscess in 2, whereas 127 had a normal or swollen pancreas. Two small cysts resolved spontaneously, eight were cured after ultrasonically guided needle aspiration or catheter drainage, and cystogastrostomy was necessary in four cases. One patient refused treatment. Abscesses requiring surgical drainage developed in four of the patients with pseudocysts. The study showed that pseudocysts may appear as early as within 1 week of the first episode of acute pancreatitis. Some pseudocysts may resolve spontaneously, and ultrasonically guided aspiration or drainage may cure approximately half of the pseudocysts.