The syndromes of pancreatic pseudocysts and fluid collections.

The clinical and radiologic spectrum of pseudocysts associated with alcohol-induced pancreatitis is wide and variable. Several illustrative cases which delineate the diversity of syndromes that occur with pseudocysts are presented. A classification is proposed to facilitate a more coherent approach to the concept of pseudocysts and is based on the clinical presentation. Thus, in acute pancreatitis duct disruption and enzyme activation may result in intrapancreatic or extrapancreatic fluid collections. In calcifying chronic pancreatitis duct obstruction may result in pseudocysts of the head, body, or tail of the pancreas, which can enlarge and penetrate into extrapancreatic sites. This subdivision will assist in elucidating the natural history of pseudocysts and pancreatic fluid collections. Furthermore, it may establish new guidelines for diagnosis and therapy.