Management of fluid collections and necrosis in acute pancreatitis.

G. G. Tsiotos, M. G. Sarr

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

According to the Atlanta classification, the most widely accepted clinically based classification system for acute pancreatitis, four pathologic entities of fluid collections and necrosis are recognized. Acute fluid collections occur early as an exudative reaction to the pancreatic inflammation, have no fibrous wall, and resolve spontaneously. Pancreatic necrosis, the most severe form of acute pancreatitis, is diagnosed on dynamic contrast-enhanced computerized tomography and requires early aggressive cardiorespiratory resuscitation, nutritional support, and appropriate systemic antibiotics to prevent superinfection. Development of infection (infected necrosis) is the indication for operative debridement, preferably as late in the course of the disease as possible. Acute pseudocysts are collections of pancreatic, enzyme-rich fluid caused by pancreatic ductal disruption that occur 3 to 6 weeks after onset of acute pancreatitis and have a well-defined, nonepithelial fibrous wall. If communication with the ductal system is present, internal enteric drainage (either operative or endoscopic) is more effective; if communication is not present, the pseudocysts are amenable to percutaneous drainage. A pancreatic abscess is an infected, circumscribed peripancreatic collection, associated with minimal or no parenchymal necrosis, that occurs late (4 to 6 weeks) after onset of severe pancreatitis and may represent an infected pseudocyst; percutaneous drainage is the treatment of choice.

Original languageEnglish (US)
Pages (from-to)139-144
Number of pages6
JournalCurrent Gastroenterology Reports
Volume1
Issue number2
StatePublished - Apr 1999

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Pancreatitis
Necrosis
Drainage
Pancreatic Pseudocyst
Superinfection
Nutritional Support
Debridement
Resuscitation
Abscess
Tomography
Anti-Bacterial Agents
Inflammation
Enzymes
Infection
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Management of fluid collections and necrosis in acute pancreatitis. / Tsiotos, G. G.; Sarr, M. G.

In: Current Gastroenterology Reports, Vol. 1, No. 2, 04.1999, p. 139-144.

Research output: Contribution to journalArticle

Tsiotos, G. G. ; Sarr, M. G. / Management of fluid collections and necrosis in acute pancreatitis. In: Current Gastroenterology Reports. 1999 ; Vol. 1, No. 2. pp. 139-144.
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