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2. PANCREATIC CYSTS
 As a result of the local necrosis that occurs at the time of acute
pancreatitis, collections of fluid may form in the the pancreas.
 These become fibrous tissue and are called pancreatic pseudocysts.
 They are the most common type of pancreatic cysts.
 Less common cysts occur as a result of congenital anomalies or are
secondary to chronic pancreatitis or trauma to the pancreas.

3.  Diagnosis of pancreatic cysts and pseudocysts is made by ultrasound,
computed tomography, and ERCP.
 ERCP may be used to define the anatomy of the pancreas and evaluate
the patency of pancreatic drainage.
 Pancreatic pseudocysts may be of considerable size.
 Because of their location behind the posterior peritoneum, when they
enlarge they impinge on and displace the stomach or the colon, which
are adjacent.
 Eventually, through pressure or secondary infection, they produce
symptoms and require drainage.

4.  Drainage into the gastrointestinal tract or through the skin and
abdominal wall may be established.
 In the latter instance, the drainage is likely to be profuse and
destructive to tissue because of the enzyme contents.
 Hence, steps must be taken to protect the skin near the drainage site
from excoriation.
 Ointments protect the skin if they are applied before excoriation takes
place.

5.  Another method involves the constant aspiration of digestive
secretions from the drainage tract by means of a suction apparatus, so
that skin contact with the digestive enzymes is avoided.
 This method requires expert nursing attention to ensure that the
suction tube does not become dislodged and suction is not interrupted.
 Consultation with an enterostomal therapist is indicated to identify
appropriate strategies to maintain drainage and protect the skin.
 Thanking you.