Acute pancreatitis with infected necrosis

Case contributed by Dr Bruno Di Muzio

Presentation

Patient hospitalised for five days with a diagnosis of pancreatitis.

Patient Data

Age: 73
Gender: Female

CT Abdomen and pelvis

Modality: CT

Extensive pancreatic inflammation associated with multiple small adjacent collections, one of these, the bigger one, permeates the pancreatic parenchyma in the body and tail (pancreatic necrosis), with gas bubbles within.

Note: Failure technique allowed the small injection of contrast medium prior to acquisitions, so renal excretion is seen.

Case Discussion

One of the most feared complications of acute pancreatitis is infected pancreatic necrosis.

The only sign on CT that allows the diagnosis of infected pancreatic necrosis is the identification of gas bubbles through the parenchymal necrosis, since the patient has not undergone any intervention or operated upon. This condition is also know as emphysematous pancreatitis.

Some authors advocate the differentiation between infected pancreatic necrosis and pancreatic abscess, reserving the use of the term pancreatic abscess for the condition in which identifies a more well-defined accumulation of liquid, while the infected pancreatic necrosis would be more diffuse, ill-defined and with anarchic distribution of gas inside.

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Case Information

rID: 26454
Case created: 22nd Dec 2013
Last edited: 22nd Dec 2016
Inclusion in quiz mode: Included

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