A pancreatic abscess is a well-encapsulated collection of liquid pus, in or around the pancreas. It denotes an end stage of pancreatic inflammation when infection supervenes. Necrotic debris initially results from the action of pancreatic enzymes and then becomes the focus of bacterial infection.
Patients usually present with a swinging pyrexia and tachycardia, several weeks after an attack of acute pancreatitis. The diagnosis is confirmed with ultrasound and CT, and with aspiration of pus.
Surgical drainage and removal of necrotic debris is indicated. A drain is placed under CT guidance. Percutaneous drainage is hindered by viscosity, loculation and retroperitoneal tracking. In severe cases, conventional surgical operation is required.
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