Pancreatic Abscess and Infected Pancreatic Necrosis: Different Local Septic Complications in Acute Pancreatitis

Summary. Introduction. The search for objective methods for diagnosing the form and severity of acute pancreatitis, accurate prediction and timely prevention of infectious complications in this surgical pathology is of great practical importance for modern medicine. Materials and methods. According to clinical, morphological and bacteriological data, groups of patients were selected. The first group included 33 patients with sterile pancreatic necrosis (SP), the second group consisted of 29 patients with infected pancreatic necrosis (IP). Results and discussion. The program of differential diagnosis of sterile and infected pancreatic necrosis with calculation of the index of differential diagnosis (IDD) for each clinical-laboratory and instrumental indicator used in this system is developed. The development and evaluation of diagnostic possibilities of the method of verification of purulent-septic complications of acute pancreatitis and the transition of a sterile form of pancreatic necrosis to an infected one was carried out. Conclusions. The use of the developed method of diagnosis of sterile and infected pancreatic necrosis with the calculation of the index of differential diagnosis allowed in 93% of cases to distinguish sterile pancreatic necrosis from infected and timely determine the scope and tactics of treatment.

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PYO-SEPTIC COMPLICATIONS OF SEVERE NECROTIZING FORMS OF ACUTE PANCREATITIS

Modern medical technologies ◽

10.34287/mmt.3(42).2019.9 ◽

2019 ◽

Vol 42 (3) ◽

pp. 37-40

Author(s):

Veligotsky N. N. ◽

Arutyunov S. E. ◽

Klymenko M. V. ◽

Aleksanyan K, A.

Keyword(s):

Acute Pancreatitis ◽

Minimally Invasive ◽

Pancreatic Necrosis ◽

Fine Needle Biopsy ◽

Infected Pancreatic Necrosis ◽

Septic Complications ◽

Blood Calcium ◽

Surgical Interventions ◽

Surgical Tactics ◽

Instrumental Methods

Purpose of the study. Develop an algorithm for the diagnosis and treatment of purulent-septic complications of severe necrotizing forms of acute pancreatitis. Materials and methods. 5400 patients with acute pancreatitis were treated. To determine the infected pancreatic necrosis, the blood calcium level, and blood procalcitonin were studied, and a fine-needle biopsy was performed. Surgical interventions were performed in 874 (16,2%) patients who underwent 1057 surgical interventions. Results. 782 minimally invasive interventions were performed in 645 patients: video laparoscopic – 608 (77,7%), puncture-draining (under ultrasound control) – 102 (13,0%), endoscopic – 38 (4,9%). The following purulent-septic complications of severe forms of acute pancreatitis were revealed: infected pancreatic necrosis in 189 (17,9%), infected peripancreonecrosis in 167 (15,8%), infected pseudocyst in 109 (12,5%) patients. 173 (19,8%) single-stage operative interventions were performed, 56 (6,4%) open-stage multistage patients were performed, and extended necrsequestrectomy was performed. Among minimally invasive interventions, minilaparotomy and lumbotomy were performed in 34 (4,3%). Conclusion. The use of monitoring laboratory and instrumental methods of research in the diagnosis of severe forms of acute pancreatitis and its complications allows you to determine in time the degree and volume of necrotic lesions of the pancreas and develop surgical tactics. Keywords: acute pancreatitis, pancreatonecrosis,purulent-septic complications.

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HSV encephalitis after successful minimally invasive debridement for infected pancreatic necrosis: A case of rare central nervous system complication

European Journal of Inflammation ◽

10.1177/20587392211000571 ◽

2021 ◽

Vol 19 ◽

pp. 205873922110005

Author(s):

Bei Lu ◽

Yang Cai ◽

Junjie Yin ◽

Jingrui Wang ◽

Zhong Jia ◽

...

Keyword(s):

Central Nervous System ◽

Acute Pancreatitis ◽

Nervous System ◽

Herpes Simplex ◽

Minimally Invasive ◽

Pancreatic Necrosis ◽

Infected Pancreatic Necrosis ◽

Percutaneous Catheter Drainage ◽

Central Nervous System Complication ◽

Simplex Virus

Patients with acute pancreatitis (AP) often suffer tough complications, some of which are fatal. The early diagnosis and definite treatment of central nervous system (CNS) complications have not been fully achieved yet, which seriously affects the mortality of severe acute pancreatitis (SAP). We present a case of infected pancreatic necrosis (IPN) in a 62-year Chinese man who developed acute herpes simplex encephalitis (HSE) caused by herpes simplex virus type 1 (HSV-1) after favorable minimally invasive retroperitoneal approaches (MIRAs). The patient was successfully treated with 115 days stayed in our hospital. The MIRAs included image-guided retroperitoneal percutaneous catheter drainage (PCD), nephroscopic pancreatic necrosectomy (NPN), and ultrasonic pneumatic lithotripsy system (UPLS) assisted non-narcotic sinus track necrosectomy (NSN). HSE is relatively rare and potentially life threatening. We attempt to discuss the probable risk factors and how the relatively rare HSE are related to the patients of SAP with latent HSV.

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Influence of Etiological Factors on Infected Pancreatic Necrosis and Other Local Complications in Acute Pancreatitis

HPB ◽

10.1016/j.hpb.2019.10.2108 ◽

2019 ◽

Vol 21 ◽

pp. S407

Author(s):

Peng Dai ◽

Le Zhang

Keyword(s):

Acute Pancreatitis ◽

Pancreatic Necrosis ◽

Infected Pancreatic Necrosis ◽

Etiological Factors ◽

Local Complications

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Sa1352 MOLECULAR PHENOTYPING OF INFECTED PANCREATIC NECROSIS (IPN) IN PATIENTS WITH ACUTE PANCREATITIS: POTENTIAL FOR BIOMARKER DEVELOPMENT.

Gastroenterology ◽

10.1016/s0016-5085(20)31518-3 ◽

2020 ◽

Vol 158 (6) ◽

pp. S-327

Author(s):

Aparna Jakkampudi ◽

Priyanka Sarkar ◽

Subhaleena Sarkar ◽

Nageshwar R. Duvvur ◽

Misbah Unnisa ◽

...

Keyword(s):

Acute Pancreatitis ◽

Pancreatic Necrosis ◽

Infected Pancreatic Necrosis ◽

Molecular Phenotyping

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Risk factors and outcomes of infected pancreatic necrosis: Retrospective cohort of 148 patients admitted to the ICU for acute pancreatitis

United European Gastroenterology Journal ◽

10.1177/2050640618764049 ◽

2018 ◽

Vol 6 (6) ◽

pp. 910-918 ◽

Cited By ~ 5

Author(s):

Charlotte Garret ◽

Matthieu Péron ◽

Jean Reignier ◽

Aurélie Le Thuaut ◽

Jean-Baptiste Lascarrou ◽

...

Keyword(s):

Risk Factors ◽

Acute Pancreatitis ◽

Retrospective Cohort ◽

Pancreatic Necrosis ◽

Infected Pancreatic Necrosis

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Infected Pancreatic Necrosis due to Multidrug-Resistant Organisms and Persistent Organ failure Predict Mortality in Acute Pancreatitis

Clinical and Translational Gastroenterology ◽

10.1038/s41424-018-0056-x ◽

2018 ◽

Vol 9 (10) ◽

pp. e190 ◽

Cited By ~ 13

Author(s):

Saransh Jain ◽

Soumya Jagannath Mahapatra ◽

Swatantra Gupta ◽

Shalimar ◽

Pramod Kumar Garg

Keyword(s):

Acute Pancreatitis ◽

Organ Failure ◽

Pancreatic Necrosis ◽

Multidrug Resistant ◽

Infected Pancreatic Necrosis ◽

Persistent Organ Failure ◽

Multidrug Resistant Organisms

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Procalcitonin levels at admission as a predictor of infected pancreatic necrosis in acute pancreatitis

HPB ◽

10.1016/j.hpb.2018.06.1911 ◽

2018 ◽

Vol 20 ◽

pp. S520

Author(s):

L. Vidal ◽

E. Pando ◽

P. Alberti ◽

J.N. Hidalgo ◽

L. Blanco ◽

...

Keyword(s):

Acute Pancreatitis ◽

Pancreatic Necrosis ◽

Infected Pancreatic Necrosis

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A rare case of emphysematous pancreatitis: managing a killer without the knife

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa086 ◽

2020 ◽

Vol 2020 (6) ◽

Author(s):

Daniel Page ◽

Sujith Ratnayake

Keyword(s):

Acute Pancreatitis ◽

High Mortality ◽

Conservative Management ◽

Rare Case ◽

Pancreatic Necrosis ◽

Case Reports ◽

Small Body ◽

Severe Complication ◽

Infected Pancreatic Necrosis ◽

Pancreatic Necrosectomy

Abstract Emphysematous pancreatitis (EP) is a rare and severe complication of acute pancreatitis carrying a high mortality with only a handful of case reports and small studies reporting these cases and their management. The presence of emphysematous pancreatitis is often indicative of infected pancreatic necrosis with the mainstay of treatment being pancreatic necrosectomy; however there are cases where it may be appropriate to have a trial of conservative management, and there is a small body of evidence to support this. This paper describes a case of an 87-year-old male with acute emphysematous pancreatitis successfully managed with conservative cares.

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