The Emphysematous Pancreatitis: A Rare Complication of Acute Necrotizing Pancreatitis

Niryinganji, Révérien; Mountassir, Chorouk; Siwane, A.; Tabakh, H.; Touil, N.; Kacimi, O.; Çhikhaoui, N.

doi:10.12890/2020_001550

Cited by 4 publications

(2 citation statements)

References 4 publications

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“…Emphysematous pancreatitis (EP) is a rare variant of necrotizing pancreatitis characterized by the presence of gas within the pancreatic parenchyma or peripancreatic collection [ 1 , 2 ]. EP must be distinguished from other causes of pancreatic intraductal or parenchymal gas including endoscopic instrumentation, reflux from the duodenum after sphincterotomy, enteric fistula and end-organ infarction [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Massive emphysematous pancreatitis associated with duodenal microperforation

Mark

Hartslief

2022

Journal of Surgical Case Reports

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Emphysematous pancreatitis (EP) is a rare variant of necrotizing pancreatitis which may result from bacterial superinfection of pancreatic tissue with gas-forming organisms such as Escherichia coli and Klebsiella pneumoniae. Gas formation is a consequence of mixed acid fermentation by these species, which may colonize the inflamed pancreatic tissue by intestinal translocation, hematogenous spread or direct seeding by penetrating ulcer. Previously described cases of EP associated with penetrating ulcer are exceedingly rare and typified by focal emphysema confined to the site of fistulation, often the head of pancreas. We present a case of massive emphysematous pancreatitis with pseudoaneurysm involvement and associated duodenal microperforation. Furthermore, we describe the successful operative management of this patient, who remains well in the community.

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Section: Introductionmentioning

confidence: 99%

Massive emphysematous pancreatitis associated with duodenal microperforation

Mark

Hartslief

2022

Journal of Surgical Case Reports

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“…It is mostly known to be caused by Escherichia coli , although Pseudomonas aeruginosa , Klebsiella pneumoniae , Enterobacter , and Clostridium perfringens are also associated organisms. 3 We report a patient who presented with suspected bowel perforation and was subsequently found to have EP that was managed successfully with multidisciplinary team involvement.…”

Section: Introductionmentioning

confidence: 99%

Emphysematous Pancreatitis Mimicking Bowel Perforation

et al. 2021

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Necrotizing pancreatitis complicated by retroperitoneal emphysema: two case reports

et al. 2022

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Background Emphysematous pancreatitis is acute pancreatitis associated with emphysema based on imaging studies and has been considered a subtype of necrotizing pancreatitis. Although some recent studies have reported the successful use of conservative treatment, it is still considered a serious condition. Computed tomography (CT) scan is useful in identifying emphysema associated with acute pancreatitis; however, whether the presence of emphysema correlates with the severity of pancreatitis remains controversial. In this study, we managed two cases of severe acute pancreatitis complicated with retroperitoneal emphysema successfully by treatment with lavage and drainage. Case presentation Case 1: A 76-year-old man was referred to our hospital after being diagnosed with acute pancreatitis. At post-admission, his abdominal symptoms worsened, and a repeat CT scan revealed increased retroperitoneal gas. Due to the high risk for gastrointestinal tract perforation, emergent laparotomy was performed. Fat necrosis was observed on the anterior surface of the pancreas, and a diagnosis of acute necrotizing pancreatitis with retroperitoneal emphysema was made. Thus, retroperitoneal drainage was performed. Case 2: A 50-year-old woman developed anaphylactic shock during the induction of general anesthesia for lumbar spine surgery, and peritoneal irritation symptoms and hypotension occurred on the same day. Contrast-enhanced CT scan showed necrotic changes in the pancreatic body and emphysema surrounding the pancreas. Therefore, she was diagnosed with acute necrotizing pancreatitis with retroperitoneal emphysema, and retroperitoneal cavity lavage and drainage were performed. In the second case, the intraperitoneal abscess occurred postoperatively, requiring time for drainage treatment. Both patients showed no significant postoperative course problems and were discharged on postoperative days 18 and 108, respectively. Conclusion Acute pancreatitis with emphysema from the acute phase highly indicates severe necrotizing pancreatitis. Surgical drainage should be chosen without hesitation in necrotizing pancreatitis with emphysema from early onset.

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The Emphysematous Pancreatitis: A Rare Complication of Acute Necrotizing Pancreatitis

Cited by 4 publications

References 4 publications

Massive emphysematous pancreatitis associated with duodenal microperforation

Massive emphysematous pancreatitis associated with duodenal microperforation

Emphysematous Pancreatitis Mimicking Bowel Perforation

Necrotizing pancreatitis complicated by retroperitoneal emphysema: two case reports

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