Ans: A (Acute Pancreatitis) Ref: Sabiston Textbook of Surgen: 19th Edition, Pg 1524-25 & Schwartz's Principles of Surgery. 9th EditionExplanation:"Pancreatic pseadocysts occur usually as a complication of pancreatitis, although sonic occur after trauma" {Ref: Schwartz}.Pancreatic PseudocystsPancreatic pseudocysts occur in 59c to 15% of patients who have peri pancreatic fluid collections after Acute Pancreatitis.By definition, the capsule of a pseudocyst is composed of collagen and granulation tissue and it is not lined by epithelium.The fibrotic reaction typically requires at least 4 to S weeks to develop.Clinical featuresUpto 50% develop symptomsAbdominal painEarly satietyNauseaWeight lossDiagnosisElevated pancreatic enzyme levels in plasma is suggestiveCT or MRI can confirms the diagnosisEUS with FNA is indicated for patients in whom the diagnosis is not clearCyst Fluid analysisHigh amylaseAbsence of mucinLow carcinoem-bryonic antigen (CEa) levelsManagementAsympomatic patientsOnly observation is indicated because spontaneous regression has been documented in up to 70% of asymptomatic patients .Factors favoring spontaneous regressionPseudocysts smaller than 4 cm in diameterLocated in the tailNo evidence of pancreatic duct obstruction or communication with the main pancreatic duct.Symptomatic PatientsManagement options areEndoscopic ManagementTransgastric ./ transduodenal endoscopic drainage - for pseudocysts in close contact (defined as <1 cm) with the stomach and duodenum.Transpapillary drainage can be attempted in pancreatic pseudocysts communicating with the main pancreatic duct.For pancreatic duct stricture is associated with a pancreatic pseudoeyst, endoscopic dilation and stent placement are indicatedSurgeryIndicated for patients with pancreatic pseudocysts that cannot he treated with endoscopic techniques and patients who fail e ndoscopi c t real men tDepends on the location of the cyst.Pancreatic pseudocysts closely attached to the stomach should be treated with a cyst- gastrostomy.Pancreatic pseudocysts located in the head of the pancreas that are in close contact with the duodenum are treated with a eystoduo- denostomyFor pseudocysts are not in contact with the stomach or duodenum the surgical treatment is a roux-en-v cystojejunostomy.Percutaneous drainagePercutaneous drainage is only indicated for septic patients secondary to pseudocyst infectionHigh incidence of external fistulaComplications of PseudocystBleedingPancreaticopleural fistulaBile duct obstructionDuodenal obstructionRupture into the abdominal cavityInfection