Suppurative Pancreatitis With Associated Liver Abscess

Abstract

IN ACCORD with our own experience,1 recent trends in the literature have emphasized the decreased mortality of acute pancreatitis when treated by the conservative nonoperative method, reserving operation for the complications of this disease, namely, pseudocyst and abscess. Within the past three years I9 cases of acute pancreatitis have been encountered in the Jefferson Medical College Hospital, I2 of the edematous type and seven of the hemorrhagic type. In the hemorrhagic group, pseudocyst formation occurred in two cases, and pancreatic abscess, also, in two cases. It is the purpose of this communication to present in detail one case from this series, unusual because of suppuration followed by hepatic abscess, to discuss its pathogenesis and evaluate the factors contributing to recovery.Case Report.-A. T., female, age 55, was admitted to the Surgical "A" Ward Service of the Jefferson Medicil College Hospital, September 30, I944, with the chief complaint of epigastric and right upper abdominal pain.The patient had been well until three days prior to admission, at which time she first experienced moderately severe epigastric and right upper abdominal pain. The pain was constant, did not radiate, and was accompanied by nausea and frequent episodes of vomiting of greenish-yellow material. She also had diarrhea, with passage of four loose stools daily for two days. From the onset of the attack she remained confined to bed and had fever.The past medical history revealed that the patient previously had always enjoyed excellent health. She had been free of indigestion and was able to tolerate all types of food.Physical Examination.

Acute Pancreatitis Associated with Amoebic Liver Abscess

“…Most probably two diseases might have occurred simultaneously. Pyogenic liver abscess associated with acute pancreatitis was first reported in 1945 by Shallow et al [1], which was detected perioperatively. Pyogenic liver abscess in chronic alcoholic pancreatitis that was reported by Gundling et al in 2004 was due to a pancreaticohepatic fistula [2].…”