Isolated pyogenic pancreatic abscess mimicking a neoplasm.
BACKGROUND
Pancreatic abscesses are uncommon and usually occur in the setting of pancreatitis. Isolated pyogenic pancreatic abscesses without any precipitating events are extremely rare.


METHODS
A 72-year-old man with a two month history of non-specific abdominal discomfort, distension, anorexia and weight loss was admitted for further evaluation. A computer tomography scan showed a lesion of the pancreatic head suspicious for a malignancy. Unexpectedly, Klebsialla pneumoniae was isolated from the aspiration biopsy without any evidence of malignancy. A repeat CT scan four months later showed resolution of the abscess after a six week course of antibiotic.


CONCLUSIONS
Our case highlights a rare case of isolated pyogenic pancreatic abscess secondary to Klebsialla pneumoniae mimicking an underlying pancreatic malignancy. Infective causes should be considered to avoid any unnecessary major surgery.
Chong
Vui Heng
VH
Gastroenterology Unit, Department of Medicine, Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Bandar Seri Begawan, Brunei Darussalam. chongvuih@yahoo.co.uk
D000038:Abscess / Q000175:diagnosis*; D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D007710:Klebsiella Infections / Q000175:diagnosis*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008297:Male; D010182:Pancreatic Diseases / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D013492:Suppuration / Q000175:diagnosis