Pancreatic Abscess After Alcoholic Pancreatitis

Indolent Presentation of Pancreatic Abscess

“…The most frequent presenting symptom in our series was abdominal pain (86%), as in most other se¬ ries [1][2][3][5][6][7]13,14,16,17 The literature also suggests that fever1·7·1314·16·17 and abdominal tenderness1·2·6·7·13·16·17 are the two most common physical findings. Surprisingly, we noted that 71% of our patients had a temperature less than 38.3°C on admission and that 27 patients never had a fever.…”

“…Computed tomogra¬ phic scans were obtained in 52 patients, 14 within 48 hours after admission and 38 later than 48 hours after admission.…”

Improved Survival for Patients with Pancreatic Abscess

“…However, in this series marsupialization was used infrequently and only after failure of sump drainage or when persistent bleeding was encountered after pancreatic debridement. We believe that neither procedure is superior in every case, and that the surgeon should choose between sump drainage and marsupialization based on the size and characteristics of the abscess [15,16].…”

Retroperitoneal drainage in the management of the septic phase of severe acute pancreatitis

“…Septic complications and multiple organ failure appear to be replacing hemodynamic complications as the principal cause of death in severe acute pancreatitis [3,4]. Although it has been previously reported [5,6]. In this article, we report our expe-Reprint Requests: Alberto Villaz6n S., M.D., Eugenio Su6 No.…”

“…Since it is now known that the presence of secondary bacterial infection cannot be reliably predicted by any combination of clinical parameters in patients with necrotizing pancreatitis [4], using such an approach as the principal indication for surgery may result in including low-risk patients with noninfected necrosis in the series, thereby artificially lowering the mortality rate. Most workers have resolved the clinical dilemma of differentiating the "toxemia" of pancreatic inflammation from actual bacterial infection by means of transcutaneous guided needle aspiration and culture [5].…”