What to do for the incidental pancreatic cystic lesion?

Background: Incidental pancreatic cysts are identified in 1% of all patients undergoing CT scans of the abdomen for whatever reason. The aim of this review was to provide an overview of the current evidence relating to the investigation and management of these lesions. Methods: PubMed was searched to identify relevant studies relating to the investigation and management of incidentally discovered pancreatic cystic lesions. Results: Initial investigation of incidentally discovered pancreatic cysts should be with either specific pancreas protocol CT or contrast enhanced MRI with MRCP. The diagnostic yield of these investigations can be increased with the addition of EUS/FNA and cyst fluid analysis in appropriately selected patients. Surgical intervention may be indicated in otherwise fit patients who are identified as having mucinous neoplasms. Conclusion: Applying a systematic approach to the investigation of incidentally discovered pancreatic cysts means that in the majority of cases cyst aetiology can be accurately determined and appropriate management plans developed. (C) 2014 Elsevier Ltd. All rights reserved.