Table 1

Risk stratifying characteristics of IPMN used in the Revised Fukuoka Guidelines30

Characteristics	Action if present
Cross-sectional imaging
High- r isk s tigmata Obstructive jaundice associated with head of pancreas cyst Enhancing mural nodule ≥5 mm Main pancreatic duct ≥ 10 mm	Consider surgery in fit patients
Worrisome features Clinical—pancreatitis Radiological Cyst≥3 cm Enhancing mural nodule < 5mm Thickened/enhancing cyst walls Main pancreatic duct size 5-9 mm Abrupt change in calibre of pancreatic duct with distal pancreatic atrophy Lymphadenopathy Elevated serum CA19-9 Cyst growth rate ≥ 5 mm/2 years	Perform endoscopic ultrasound evaluation
EUS features Definite mural nodule ≥ 5 mm Main duct features suspicious for involvement Cytology suspicious or definite for malignancy	Consider surgery in fit patients