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Emphysematous Pancreatitis
- Severe
complication of acute pancreatitis
- Pathophysiology
of pancreatitis is a chain of events that result from blockage of the
pancreatic duct with subsequent release of pancreatic enzymes into the
interstitium of the gland
- Most
common etiologies of acute pancreatitis are cholelithiasis and alcoholism
- If
necrosis occurs, it tends to occur early in course of disease
- Diagnosis
depends upon clinical presentation and presence of gas in retroperitoneum
- Diagnosis
of necrosis
- Focal
or diffuse
- Well-marginated
- Area
of parenchymal non-enhancement
- >3cm
- Infected
pancreatic necrosis recognized at helical CT as
- Bubbles
of gas within areas of pancreas
- Or,
collection of gas and tissue within the retroperitoneum
![Emphysematous Pancreatitis](../../caseofweek/caseoftheweekpix/cow117.jpg)
Emphysematous Pancreatitis. Axial, enhanced CT scans of the upper abdomen show
extensive gas in the region of the body and
tail of the pancreas with infiltration of the peripancreatic fat
- E. Coli
can infect necrotic pancreas
- Produces
gas in body of pancreas and retroperitoneum
- Emphysematous
pancreatitis warrants
- Early
use of antibiotics
- Percutaneous
drainage of fluid collections
- If
no response
- Surgical
resection of infected necrotic tissue
- Carries
grave prognosis
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