They also tend to rupture, and have shown that larger cysts have a higher likelihood to become more symptomatic, even needing surgery.[12] If no signs of infection are present, initial treatment may include conservative measures such as bowel rest (NPO), parenteral nutrition (TPN), and observation. If symptoms do not improve, then endoscopic drainage may be necessary. The majority of pseudocysts can be treated endoscopically; surgical intervention is rarely necessary.[13]