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Pancreatic Necrosis and Gas in the Retroperitoneum: Treatment with Antibiotics Alone
- Source :
- Clinics, Clinics, Volume: 72, Issue: 2, Pages: 87-94, Published: FEB 2017, Clinics, Vol 72, Iss 2, Pp 87-94, Clinics; v. 72 n. 2 (2017); 87-94, Clinics; Vol. 72 Núm. 2 (2017); 87-94, Clinics; Vol. 72 No. 2 (2017); 87-94, Universidade de São Paulo (USP), instacron:USP
- Publication Year :
- 2017
- Publisher :
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 2017.
-
Abstract
- OBJECTIVE: To present our experience in the management of patients with infected pancreatic necrosis without drainage. METHODS: The records of patients with pancreatic necrosis admitted to our facility from 2011 to 2015 were retrospectively reviewed. RESULTS: We identified 61 patients with pancreatic necrosis. Six patients with pancreatic necrosis and gas in the retroperitoneum were treated exclusively with clinical support without any type of drainage. Only 2 patients had an APACHE II score >;8. The first computed tomography scan revealed the presence of gas in 5 patients. The Balthazar computed tomography severity index score was >;9 in 5 of the 6 patients. All patients were treated with antibiotics for at least 3 weeks. Blood cultures were positive in only 2 patients. Parenteral nutrition was not used in these patients. The length of hospital stay exceeded three weeks for 5 patients; 3 patients had to be readmitted. A cholecystectomy was performed after necrosis was completely resolved; pancreatitis recurred in 2 patients before the operation. No patients died. CONCLUSIONS: In selected patients, infected pancreatic necrosis (gas in the retroperitoneum) can be treated without percutaneous drainage or any additional surgical intervention. Intervention procedures should be performed for patients who exhibit clinical and laboratory deterioration.
- Subjects :
- Adult
Male
medicine.medical_specialty
Percutaneous
Necrosis
Adolescent
medicine.medical_treatment
Necrotizing Pancreatitis
030230 surgery
03 medical and health sciences
0302 clinical medicine
Acute Pancreatitis
Infected Pancreatic Necrosis
Medicine
Retroperitoneal space
Humans
Retroperitoneal Space
Aged
Retrospective Studies
lcsh:R5-920
business.industry
Pancreatitis, Acute Necrotizing
Retrospective cohort study
General Medicine
Clinical Science
Length of Stay
Middle Aged
medicine.disease
Surgery
Anti-Bacterial Agents
Treatment
medicine.anatomical_structure
Parenteral nutrition
Pancreatitis
Acute pancreatitis
030211 gastroenterology & hepatology
Cholecystectomy
Female
Gases
medicine.symptom
lcsh:Medicine (General)
business
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 19805322 and 18075932
- Volume :
- 72
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinics
- Accession number :
- edsair.doi.dedup.....1a3d87a80d570223cdeefeca18f18b2d