Percutaneous treatment of a patient with infected necrotizing pancreatitis.
BACKGROUND
A 50-year-old man with an acute episode of alcohol-induced chronic edematous pancreatitis and an inflammatory stenosis of the biliary tract was treated by implantation of a plastic endoprosthesis at a rural hospital in Germany. Because of his worsening condition, the patient was referred to the intensive care unit of the University Hospital, Regensburg, Germany. Contrast-enhanced CT revealed complete necrosis of the body and tail of the pancreas, formation of large retrogastric and paraduodenal fluid collections, and fluid along Gerota's fascia, as well as in the paracolic gutters. Antibiotic treatment was adjusted according to the results of microbiological testing after diagnostic puncture of the necrotic cavity.


METHODS
CT scan, CT-guided fine-needle aspiration and fluoroscopy.


METHODS
Infected acute necrotizing pancreatitis.


RESULTS
Interventional treatment using large-bore percutaneous catheters to perform percutaneous necrosectomy, fragmentation of necrotic pancreatic tissue with a snare catheter and dormia basket, and aspiration. Parenteral nutrition and antibiotics were also administered.
Zorger
Niels
N
Department of Radiology, University of Regensburg, Germany. nielszorger@aol.com
Hamer
Okka W
OW
Feuerbach
Stefan
S
Borisch
Ingitha
I
D001424:Bacterial Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D044963:Biopsy, Fine-Needle; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013396:Suction / Q000379:methods; D014057:Tomography, X-Ray Computed