scholarly journals DIFFERENTIAL DIAGNOSIS OF STERILE AND I NFECTED PANCREONECROSIS

2021 ◽  
pp. 31-35
Author(s):  
V. V. Boyko ◽  
V. M. Lykhman ◽  
A. O. Merkulov ◽  
D. O. Myroshnychenko ◽  
S. V. Tkach ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Differential Diagnosis ◽  
Pancreatic Necrosis ◽  
Clinical Laboratory ◽  
Practical Importance ◽  
Modern Medicine ◽  
Infectious Complications ◽  
Infected Pancreatic Necrosis ◽  
Septic Complications ◽  
Great Practical Importance

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.

scholarly journals PYO-SEPTIC COMPLICATIONS OF SEVERE NECROTIZING FORMS OF ACUTE PANCREATITIS

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.

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

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.

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

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

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

2018 ◽  
Vol 6 (6) ◽  
pp. 910-918 ◽  
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

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

HPB ◽  
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

scholarly journals Acute necrotising pancreatitis - causes of deaths: single-centre retrospective study

2019 ◽  
Vol 12 (1) ◽  
pp. 29-37
Author(s):  
Denis Vladimirovich Mizgirev ◽  
Valeriy Vladimirovich Kremlev ◽  
Lyudmila Aleksandrovna Neledova ◽  
Victor Nikolaevich Pozdeev ◽  
Anastasiya Andriyanovna Katysheva ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Pancreatic Necrosis ◽  
Abdominal Cavity ◽  
Infectious Complications ◽  
Endotoxin Shock ◽  
Invasive Treatment ◽  
Surgical Interventions ◽  
Late Mortality ◽  
Causes Of Deaths

Relevance. There is a discussion about the prevalence of early or late mortality and the main causes of death in different phases of acute pancreatitis. Analysis of mortality is important for the determination of ways to improve the results of treatment of pancreatic necrosis. Aim of the research is analysis of the structure, timing characteristics and causes of deaths in pancreatic necrosis, the effect of the configuration of parapancreatitis and surgical tactics on the outcome of the disease. Materials and methods. Retrospective single-center study of lethal outcomes in acute pancreatitis was performed, the structure of mortality, cases of discrepancies in diagnoses, the timing of the onset and causes of deaths of patients were studied. The lethal outcomes were compared in the operated patients, the frequency of the mesentery root involvement, the indications and the timing of the interventions were assessed. Results. The ratio of early and late mortality was 45,2% to 54,8%, respectively. The main causes of early mortality – endotoxin shock and multi-organ failure, late one – infectious complications. In 9,6% of the patients, the diagnosis was made only with an autopsy. The prognostic value of the SOFA and SAPS II scales is characterized as low. The tactics of surgical treatment has changed in favour of minimally invasive surgery. The average conversion time for ineffective percutaneous procedures was 21,4 days. The involvement of mesentery in parapancreatitis was often accompanied by a breakthrough of the abscess into the abdominal cavity. Conclusion. The surgical component of the reduction in mortality is the rejection of unreasonable surgical interventions, the earlier conversion to "traditional" operations in case of ineffective minimally invasive treatment and the allocation of "central" localization of parapancreatitis as a serious prognostic factor of the course of severe pancreatitis.

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

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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