[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Pancreas](https://durgical.com/en/general-pathology/areas/pancreas/) › Non-neoplastic pancreatic cysts: congenital cysts and pseudocysts

# Non-neoplastic pancreatic cysts: congenital cysts and pseudocysts

- Lesion

A pseudocyst is a pocket of pancreatic fluid walled off by scar after pancreatitis; it has no lining of cells.

Updated Nov 12, 2026

## Key points

- Pseudocysts are the most common pancreatic cysts and have no epithelial lining.
- They follow acute (often alcoholic) pancreatitis or trauma.
- Contents: fluid rich in amylase and lipase, necrotic debris and blood.
- Many resolve; others can become infected, bleed, rupture or compress nearby organs.
- Congenital cysts: thin-walled, lined by cuboidal or flat epithelium; with ADPKD, von Hippel-Lindau, cystic fibrosis.

## What it is

Most cystic lesions of the pancreas are either pseudocysts or neoplasms. Pseudocysts follow acute pancreatitis or trauma, when liquefied necrotic tissue and enzyme-rich fluid are walled off by granulation tissue and fibrosis without an epithelial lining. True congenital cysts are lined by epithelium and arise from anomalous duct development; multiple cysts occur in autosomal dominant polycystic kidney disease, von Hippel-Lindau disease and cystic fibrosis.

## Structure

- Pseudocyst: single cavity, often next to the pancreas in the lesser sac; wall of fibrous and granulation tissue with hemosiderin and macrophages, no epithelium.
- Congenital cyst: unilocular thin-walled cyst with serous fluid and an epithelial lining.

## Step by step

- Acute pancreatitis or trauma causes necrosis of pancreatic and peripancreatic tissue.
- Necrotic tissue liquefies and enzyme-rich fluid collects.
- Granulation tissue surrounds the collection.
- Over weeks, fibrous tissue matures into a wall without epithelium.
- The cyst persists, resolves, or becomes infected or bleeds.

## Pseudocyst vs congenital cyst

| Feature | Pseudocyst | Congenital cyst |
| --- | --- | --- |
| Lining | None (fibrous and granulation tissue) | Epithelium |
| Origin | After pancreatitis or trauma | Developmental duct anomaly |
| Fluid | Enzyme-rich, turbid or bloody | Clear serous |
| Associations | Alcohol, gallstone pancreatitis | ADPKD, von Hippel-Lindau, cystic fibrosis |

## Memory aid

Pseudo means false: a pseudocyst has walls of scar but no true lining of cells.

## Test yourself

Think of the answer, then tap the question to see it.

## What feature makes a pancreatic pseudocyst a 'pseudo' cyst?

It has no epithelial lining; its wall is granulation and fibrous tissue.

## What usually precedes a pancreatic pseudocyst?

An episode of acute pancreatitis (often alcoholic) or pancreatic trauma.

## Which inherited diseases cause true pancreatic cysts?

Autosomal dominant polycystic kidney disease, von Hippel-Lindau disease and cystic fibrosis.

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## Connections

## Related 4

- [Acute pancreatitis: morphology and complications](https://durgical.com/en/general-pathology/acute-pancreatitis-morphology-and-complications/)
- [Cystic pancreatic neoplasms](https://durgical.com/en/general-pathology/cystic-pancreatic-neoplasms/)
- [Congenital anomalies of the pancreas](https://durgical.com/en/general-pathology/congenital-anomalies-of-the-pancreas/)
- [Granulation tissue and scar formation](https://durgical.com/en/general-pathology/granulation-tissue-and-scar-formation/)

## Related conditions 4

- [Acute pancreatitis](https://durgical.com/en/conditions/acute-pancreatitis/)
- [Chronic pancreatitis](https://durgical.com/en/conditions/chronic-pancreatitis/)
- [Autosomal dominant polycystic kidney disease](https://durgical.com/en/conditions/autosomal-dominant-polycystic-kidney-disease/)
- [Cystic fibrosis](https://durgical.com/en/conditions/cystic-fibrosis/)

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: [Pancreatic pseudocyst: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/000272.htm) (MedlinePlus, US National Library of Medicine, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/non-neoplastic-pancreatic-cysts-congenital-cysts-and-pseudocysts/