Minimally invasive treatment of acute intrahepatic fluid collections with acute biliary pancreatitis.
BACKGROUND
Peripancreatic fluid collection suggests the anatomical-clinical scenario of necrotizing acute pancreatitis. However, intrahepatic fluid collection is a rare occurrence with fewer than 30 cases being reported in the medical literature. We describe 2 cases of intrahepatic fluid collection in 2 patients with acute biliary pancreatitis and discuss the therapeutic possibilities.


METHODS
The first case report is that of a 68-year-old female with a diagnosis of acute biliary pancreatitis with several necrotizing fluid collections and a large infected intrahepatic collection in the left lobe. The patient was successfully treated by percutaneous US/CT guided drainage. The second case report is that of a 72-year-old female with a diagnosis of acute biliary pancreatitis with several peripancreatic fluid collections and a voluminous intrahepatic fluid collection in the left lobe that caused epigastric pain. This patient was also successfully treated with percutaneous US/CT guided drainage.


CONCLUSIONS
Intrahepatic fluid collection in the course of acute biliary pancreatitis is a rare occurrence. The therapeutic approach is the same as that for pancreatic and peripancreatic fluid collections. In case of infection, the patient undergoes percutaneous US/CT guided drainage. This therapeutic procedure can be added to the therapeutic program for necrotizing acute biliary pancreatitis together with ERCP/ES and videolaparocholecystectomy (VLC).
Neri
Vincenzo
V
University of Foggia, Division of General Surgery, Ospedali Riuniti Hospital, Foggia, Italy. v.neri@unifg.it
Ambrosi
Antonio
A
Fersini
Alberto
A
Tartaglia
Nicola
N
Valentino
Tiziano Pio
TP
D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000150:complications*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000601:surgery*; D010195:Pancreatitis / Q000150:complications / Q000209:etiology / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed