Emphysematous pancreatitis
Citation, DOI, disclosures and article data
At the time the article was created Bruno Di Muzio had no recorded disclosures.
View Bruno Di Muzio's current disclosuresAt the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosures- gangrenous pancreatitis
- emphysematous pancreatitis (EP)
Emphysematous pancreatitis is an unusual complication of acute pancreatitis caused by necrotising infection of the pancreas. It is associated with gas-forming bacteria and characterised by the presence of gas within or around the pancreas 1.
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Pathology
Infection with gas-forming bacteria such as
Escherichia coli
Clostridium perfringens
Staphylococcus spp.
Streptococcus spp
Klebsiella spp.
Pseudomonas spp.
Gas associated with infection is generally thought to consist of carbon dioxide and nitrogen secondary to the fermentation of glucose by some species of bacteria.
Radiographic features
Computed tomography is the imaging modality of choice because of its sensitivity and specificity in detecting gas bubbles 2.
Treatment and prognosis
This condition carries a high mortality rate. Percutaneous drainage of the fluid collection and, if there is no clinical response to support measures, surgical resection of the infected necrotic tissue.
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Differential diagnosis
gas introduced by recent instrumentation, surgery (e.g. post-ERCP) or trauma
enteric fistula formation and reflux from an adjacent hollow viscus
References
- 1. Kvinlaug K, Kriegler S, Moser M. Emphysematous pancreatitis: a less aggressive form of infected pancreatic necrosis?. Pancreas. 2009;38 (6): 667-71. doi:10.1097/MPA.0b013e3181a9f12a - Pubmed citation
- 2. Wig JD, Kochhar R, Bharathy KG et-al. Emphysematous pancreatitis. Radiological curiosity or a cause for concern?. JOP. 2008;9 (2): 160-6. Pubmed citation
- 3. Niryinganji Révérien, Mountassir Shuruk, Siwane Abdellatif et al. The Emphysematous Pancreatitis: A Rare Complication of Acute Necrotizing Pancreatitis. European Journal of Case Reports in Internal Medicine. 2020;(Vol 7 No 6). doi:10.12890/2020_001550
- 4. Martínez D, Belmonte M, Kośny P, Ghitulescu M, Florencio I, Aparicio J. Emphysematous Pancreatitis: A Rare Complication. European Journal of Case Reports in Internal Medicine. 2018;5(11):1. doi:10.12890/2018_000955 - Pubmed
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