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 Reabal Najjar had no financial relationships to ineligible companies to disclose.
View Reabal Najjar's current disclosures- gangrenous pancreatitis
- emphysematous pancreatitis (EP)
Emphysematous pancreatitis is an unusual complication of acute pancreatitis caused by necrotizing infection of the pancreas. It is associated with gas-forming bacteria and characterized 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 perfrigens
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 R, Mountassir C, Siwane A et al. Emphysematous Pancreatitis: A Rare Complication of Acute Necrotizing Pancreatitis. Eur J Case Rep Intern Med. 2020;7(6):001550. doi:10.12890/2020_001550
- 4. Martínez D, Belmonte M, Kośny P, Ghitulescu M, Florencio I, Aparicio J. Emphysematous Pancreatitis: A Rare Complication. Eur J Case Rep Intern Med. 2018;5(11):000955. doi:10.12890/2018_000955
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