It is caused by secondary infection of necrotic tissue from acute pancreatitis or complicated pseudocysts and can occur in any part of the pancreas, with intestinal bacilli being the main pathogenic bacteria. Abscess rupture and erosion of adjacent organs can lead to intestinal fistula or bleeding.

bubble_chart Diagnosis

1. Symptoms

After the symptoms of acute pancreatitis improve, chills, high fever, abdominal pain, leukocytosis, and elevated serum amylase may reappear and persist for more than a week.

2. Signs

A tender mass may be palpated in the upper abdomen, borborygmus is weakened, 50% of patients have jaundice, and blood bilirubin is elevated.

3. Auxiliary examinations

(1) Positive blood culture. (2) X-ray examination. The left diaphragm is elevated, left lung atelectasis, and pleural effusion. Abdominal X-ray shows gastrointestinal gas accumulation, transverse colon paralysis, and gastric displacement. (3) B-ultrasound examination. A localized spherical mass filled with fluid and necrotic tissue with light spots. (4) CT examination can determine the location and size of the abscess and differentiate it from a pseudocyst. (5) Selective abdominal stirred pulse angiography. Displacement of pancreatic and small intestine blood vessels can be observed, the degree of which is related to the size of the abscess.

bubble_chart Treatment Measures

1. Treatment Principles

Thoroughly remove necrotic tissue and drain the pus completely. Appropriately select antibiotics and strengthen systemic supportive therapy.

2. Treatment Methods

(1) Double-lumen tube negative pressure suction drainage, or alternatively, place a silicone tube in the abscess cavity to drip antibiotic-containing fluid.