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Pancreatic Infected Necrosis and Abscess
R. Brooke Jeffrey, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Infected pseudocyst: Bacterial colonization of pseudocyst
            • Pancreatic abscess: Circumscribed collection of pus, in or near pancreas, containing little or no pancreatic necrosis
              • Arises as consequence of acute pancreatitis or pancreatic trauma
            • Infected necrosis: Secondary infection of necrotic pancreatic tissue in setting of acute pancreatitis

          IMAGING

          • General Features

            • Imaging Recommendations

              • CT Findings

                • MR Findings

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Seewald S et al: Long-term results after endoscopic drainage and necrosectomy of symptomatic pancreatic fluid collections. Dig Endosc. 24(1):36-41, 2012
                                  2. Haghshenasskashani A et al: Endoscopic necrosectomy of pancreatic necrosis: a systematic review. Surg Endosc. 25(12):3724-30, 2011
                                  3. van Santvoort HC et al: A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 141(4):1254-63, 2011
                                  4. Bakker OJ et al: Prevention, detection, and management of infected necrosis in severe acute pancreatitis. Curr Gastroenterol Rep. 11(2):104-10, 2009
                                  5. Sandrasegaran K et al: Disconnection of the pancreatic duct: an important but overlooked complication of severe acute pancreatitis. Radiographics. 27(5):1389-400, 2007
                                  6. Kim YH et al: Imaging diagnosis of cystic pancreatic lesions: pseudocyst versus nonpseudocyst. Radiographics. 25(3):671-85, 2005
                                  7. Sahani DV et al: Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics. 25(6):1471-84, 2005
                                  8. Balthazar EJ: Complications of acute pancreatitis: clinical and CT evaluation. Radiol Clin North Am. 40(6):1211-27, 2002
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Clinical Issues

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Definitions

                                            • Infected pseudocyst: Bacterial colonization of pseudocyst
                                            • Pancreatic abscess: Circumscribed collection of pus, in or near pancreas, containing little or no pancreatic necrosis
                                              • Arises as consequence of acute pancreatitis or pancreatic trauma
                                            • Infected necrosis: Secondary infection of necrotic pancreatic tissue in setting of acute pancreatitis

                                          IMAGING

                                          • General Features

                                            • Imaging Recommendations

                                              • CT Findings

                                                • MR Findings

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Gross Pathologic & Surgical Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Seewald S et al: Long-term results after endoscopic drainage and necrosectomy of symptomatic pancreatic fluid collections. Dig Endosc. 24(1):36-41, 2012
                                                                  2. Haghshenasskashani A et al: Endoscopic necrosectomy of pancreatic necrosis: a systematic review. Surg Endosc. 25(12):3724-30, 2011
                                                                  3. van Santvoort HC et al: A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 141(4):1254-63, 2011
                                                                  4. Bakker OJ et al: Prevention, detection, and management of infected necrosis in severe acute pancreatitis. Curr Gastroenterol Rep. 11(2):104-10, 2009
                                                                  5. Sandrasegaran K et al: Disconnection of the pancreatic duct: an important but overlooked complication of severe acute pancreatitis. Radiographics. 27(5):1389-400, 2007
                                                                  6. Kim YH et al: Imaging diagnosis of cystic pancreatic lesions: pseudocyst versus nonpseudocyst. Radiographics. 25(3):671-85, 2005
                                                                  7. Sahani DV et al: Cystic pancreatic lesions: a simple imaging-based classification system for guiding management. Radiographics. 25(6):1471-84, 2005
                                                                  8. Balthazar EJ: Complications of acute pancreatitis: clinical and CT evaluation. Radiol Clin North Am. 40(6):1211-27, 2002