He initially presented with alcohol-induced acute pancreatitis. Twenty days after the initial presentation, he re-presented with increasing pain and was found to have pancreatic necrosis and abscesses. Treatment was initiated with meropenem. [ncbi.nlm.nih.gov]

• Fever

  On the 26th day of the first intervention, the patient had fever and abdominal pain and his clinic was deteriorated. [ncbi.nlm.nih.gov]

  Symptoms Abdominal mass Abdominal pain Chills Fever Inability to eat Nausea and vomiting Signs and tests Patients with pancreatic abscesses usually have had pancreatitis. However, the complication often takes 7 or more days to develop. [coordinatedhealth.com]

  The patient improved with subsidence of fever and discharged after 4 weeks. [ijamhrjournal.org]

• Severe Pain

  For example, severe pain may suddenly develop, but it only lasts for up to a few days. [news-medical.net]

  Signs and symptoms include severe abdominal pain, nausea, vomiting, diarrhea, fever, and shock. Causes include alcohol consumption, presence of gallstones, trauma, and drugs. Inflammation of the pancreas. Inflammation of the pancreas. [icd10data.com]

  Acute pancreatitis is classically manifested by severe epigastric pain that may be referred to the back. The pain may be mild and short-lived or the attack may be fulminant, with severe pain, hypotension and shock. [atsu.edu]

  ~ Case Report A 40-year-old male was admitted with severe pain in the abdomen on December 27, 2007 The patient was a known case of diabetes on insulin therapy and also a chronic alcoholic. [ijmm.org]

• Pallor

  She was malnourished, had mild pallor and generalized oedema. There was no peripheral lymphadenopathy. Examination of the chest did not reveal any abnormality. She had an ill-defined lump in the right hypochondrium and epigastrium. [tropicalgastro.com]

  There was no pallor, icterus or cyanosis. The findings of the cardio-respiratory and nervous system examination were within normal limits. [ijpmonline.org]

  There was mild pallor noted but no icterus. The findings of the cardiovascular system were within normal limits. On auscultation, crepitations were observed at the base of the left lung. Per-abdominal examination revealed moderate ascites. [ijmm.org]

• Pleural Effusion

  Acute pancreatitis occasionally presents as pancreatic abscess with complications like pleural effusion and ascites. [ncbi.nlm.nih.gov]

  The chest X-ray showed left-sided pleural effusion. Ascitic fluid and pleural fluid tapping was performed. [ijmm.org]

  Pancreatic ascites or pleural effusion may result. Pseudocysts or abscesses may also cause hollow viscus obstruction by compression of the surrounding structures, including the colon, stomach, duodenum, and the common bile duct. [emedicine.medscape.com]

• Abdominal Pain

  On the 26th day of the first intervention, the patient had fever and abdominal pain and his clinic was deteriorated. [ncbi.nlm.nih.gov]

  Symptoms Abdominal mass Abdominal pain Chills Fever Inability to eat Nausea and vomiting Signs and tests Patients with pancreatic abscesses usually have had pancreatitis. However, the complication often takes 7 or more days to develop. [coordinatedhealth.com]

  All patients had fever (> 39°C), abdominal pain and/or tenderness, and absent peristalsis. A draining wound, abdominal mass, oliguria, ( 3 ) or leukopenia (3) was noted in 56 patients. [ohsu.pure.elsevier.com]

  Symptoms Symptoms include: Abdominal mass Abdominal pain Chills Fever Inability to eat Nausea and vomiting Exams and Tests Most people with pancreatic abscesses have had pancreatitis. However, the complication often takes 7 or more days to develop. [ufhealth.org]

• Nausea

  Symptoms Abdominal mass Abdominal pain Chills Fever Inability to eat Nausea and vomiting Signs and tests Patients with pancreatic abscesses usually have had pancreatitis. However, the complication often takes 7 or more days to develop. [coordinatedhealth.com]

  Nausea and vomiting are common. There is usually tenderness in the epigastrium, but this is absent in early disease. Leukocytosis is present. [atsu.edu]

  Symptoms include nausea, vomiting, weight loss, and oily stools. Treatment may also be a few days in the hospital for intravenous (iv) fluids, medicines to relieve pain, and nutritional support. [icd10data.com]

  Symptoms Symptoms include: Abdominal mass Abdominal pain Chills Fever Inability to eat Nausea and vomiting Exams and Tests Most people with pancreatic abscesses have had pancreatitis. However, the complication often takes 7 or more days to develop. [ufhealth.org]

• Epigastric Pain

  Abstract A 35-year-old man sought treatment for acute epigastric pain, mild jaundice, and high fever. [ncbi.nlm.nih.gov]

  The clinical presentation of pancreatitis varies from case to case, with epigastric pain, nausea and vomiting being the commonest symptoms as observed in the present case. [ijpmonline.org]

  Acute pancreatitis usually presents with epigastric pain radiating to the back, nausea and vomiting, and epigastric tenderness on palpation. [amboss.com]

  A 55-year-old man presented after 3 weeks of sharp epigastric pain radiating to the right upper quadrant, fever, and generalized weakness. He had a history of significant heroin and cocaine abuse and was currently in a methadone maintenance program. [mdedge.com]

• Abdominal Mass

  All patients had fever (> 39°C), abdominal pain and/or tenderness, and absent peristalsis. A draining wound, abdominal mass, oliguria, ( 3 ) or leukopenia (3) was noted in 56 patients. [ohsu.pure.elsevier.com]

  All 5 patients had acute pancreatitis followed by prolonged fever and development of an abdominal mass. The diagnosis was confirmed in each of them by a contrast enhanced CT scan and an ultrasound guided aspiration of pus from the pancreatic mass. [ncbi.nlm.nih.gov]

  Symptoms Abdominal mass Abdominal pain Chills Fever Inability to eat Nausea and vomiting Signs and tests Patients with pancreatic abscesses usually have had pancreatitis. However, the complication often takes 7 or more days to develop. [coordinatedhealth.com]

  Symptoms Symptoms include: Abdominal mass Abdominal pain Chills Fever Inability to eat Nausea and vomiting Exams and Tests Most people with pancreatic abscesses have had pancreatitis. However, the complication often takes 7 or more days to develop. [ufhealth.org]

• Abdominal Tenderness

  Abdominal tenderness was absent in 40% of patients. The admission amylase concentrations and white blood cell counts were normal in 36% and 23% of patients, respectively. [ncbi.nlm.nih.gov]

  […] examination Abdominal tenderness, distention, guarding Ileus with reduced bowel sounds and tympany on percussion Ascites Skin changes (rare) Cullen's sign : periumbilical ecchymosis and discoloration ( bluish-red ) Grey Turner's sign : flank ecchymosis [amboss.com]

• Jaundice

  He was successfully cured by treatment with both appropriate antibiotic and continuous PTCD for the obstructive jaundice. [ncbi.nlm.nih.gov]

  Elevation of the serum amylase (> 200 u/100 ml) and jaundice (bilirubin > 2 mg/100 ml) were reported less frequently. [ohsu.pure.elsevier.com]

• Tachycardia

  […] hypocalcemia References: [5] [6] [7] Clinical features Constant, severe epigastric pain Classically radiating towards the back Worse after meals and when supine Improves on leaning forwards Nausea, vomiting General physical examination Signs of shock : tachycardia [amboss.com]

  Resolution of fevers, tachycardia and hypotension, as well as improvement in any associated abdominal pain are all potential markers of clinical improvement in this condition, although none are specific to this diagnosis.. [clinicaladvisor.com]

• Seizure

  […] like pulmonary effusions, acute respiratory distress syndrome, mediastinal abscess, disseminated intra-vascular coagulation, acute renal failure, peptic ulceration, acute stress ulceration, and central nervous system complications like encephalopathy, seizures [ijmm.org]

  Those weighing less than 30 kg with impaired renal function should also not receive imipenem due to increased risk of seizures and thrombocytopenia in these patient populations. [clinicaladvisor.com]

• Uremia

  […] pancreas, with variable involvement of other regional tissues or remote organ system. [1] The causes of pancreatic abscess and acute pancreatitis include cholelithiaisis, ethanol abuse, trauma, metabolic causes such as hypercalcemia, diabetic ketoacidosis, uremia [ijpmonline.org]

  […] biochemical events, the exact trigger event or pathogenesis still remains elusive. [3] Predisposing factor-associated pancreatitis include cholelithiaisis, ethanol abuse, idiopathic causes, metabolic causes like diabetes ketoacidosis, hypercalcaemia, uremia [ijmm.org]

They’ll also order tests, which may include: blood workup urine analysis ultrasound X-ray MRI CT scan To distinguish among cellulitis, abscess, and phlegmon, your doctor may use intravenous gadolinium with MRI to show the outline of an abscess “wall” [healthline.com]

• Left Pleural Effusion

  […] upper quadrant May show a paucity of gas from fluid-filled bowel Left pleural effusion CT Focal or diffuse enlargement of the pancreas Heterogeneous enhancement Indistinct or shaggy margins Infiltration of the peripancreatic fat Fluid collections in [learningradiology.com]

  There was moderate ascites, left-sided basal consolidation was noted in the left lung along with mild left pleural effusion. USG liver showed diffuse Grade 1 increase in echotexture. No local solid or cystic lesion was seen. [ijpmonline.org]

• X-Ray Abnormal

  Abscesses near the diaphragm may result in chest x-ray abnormalities such as ipsilateral pleural effusion, elevated or immobile hemidiaphragm, lower lobe infiltrates, and atelectasis. CBC and blood cultures should be done. [msdmanuals.com]

• Pancreatic Calcification

  […] large cell neuroendocrine carcinoma 複合型腺神経内分泌癌 mixed adenoneuroendocrine carcinoma 膵石 pancreatic stone (calculus), pancreatolith 膵石灰化 pancreatic calcification 膵線維化 pancreatic fibrosis 花筵状線維化 storiform fibrosis 膵内胆管浸潤 intrapancreatic bile duct invasion [jsge.or.jp]

• Gastric Fistula

  The spontaneous gastric fistula was heralded by a large emesis of purulent and necrotic material in one case and copious nasogastric tube secretions of a similar material in the other. [ncbi.nlm.nih.gov]

• Staphylococcus Aureus

  We compared the 54 cases due to Streptococcus viridans with the remaining cases of left-sided endocarditis in our series, and also with cases caused by Staphylococcus aureus. [ncbi.nlm.nih.gov]

  Al compararlas con las endocarditis por Staphylococcus aureus se encontraron las mismas diferencias. [revespcardiol.org]

  Pancreatic abscesses are more likely to host enteric organisms and pathogens such as E. coli, Klebsiella pneumonia, Enterococcus faecalis, Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis, and Streptococcus species. [5] Medical therapy [en.wikipedia.org]

  Phlegmon is frequently caused by bacteria, most often group A streptococcus or Staphylococcus aureus. Bacteria may enter via a scratch, insect bite, or injury to form a phlegmon just under the skin on your finger or feet. [healthline.com]

  aureus, Enterococcus fecalis, Citrobacter species, Bacteroides species, Haemophilus influenzae and Mycobacterium tuberculosis. [1], [2], [3], [4], [5] Specific treatment for acute pancreatitis currently does not exist and management is still supportive [ijpmonline.org]

• Pancreatic Necrosis

  An ERCP is needed in most patients with pancreatic necrosis to evaluate and establish continuity of the pancreatic duct if there is ductal discontinuity. [emedicine.medscape.com]

  It expands the potential for endoscopic treatment in patients with pancreatic necrosis and/or pancreatic abscess. [ncbi.nlm.nih.gov]

• Pleural Effusion

  Acute pancreatitis occasionally presents as pancreatic abscess with complications like pleural effusion and ascites. [ncbi.nlm.nih.gov]

  The chest X-ray showed left-sided pleural effusion. Ascitic fluid and pleural fluid tapping was performed. [ijmm.org]

  Pancreatic ascites or pleural effusion may result. Pseudocysts or abscesses may also cause hollow viscus obstruction by compression of the surrounding structures, including the colon, stomach, duodenum, and the common bile duct. [emedicine.medscape.com]

The EUS-guided treatment was effective for improvement of severe inflammation of the pseudocyst as an initial treatment. However, drainage tube placement limitations pertained because the pseudocyst was present with multilocular infection. [ncbi.nlm.nih.gov]

However, CT-guided drainage is the option treatment for patients who may not tolerate an open procedure. Endoscopic treatment is at the same time a treatment option that increased in popularity over the last years. [en.wikipedia.org]

The prognosis may be worse in obese patients, after trauma, after organ transplantation, after coronary artery bypass surgery, or in idiopathic AP. [3] Morbidity/mortality In the first 48-72 hours after the onset of acute pancreatitis using the Sepsis-Related [emedicine.medscape.com]

On the basis of this experience, it is possible to establish a relationship between the gross appearance of the collection and the underlying pancreatic disease with differences in terms of prognosis, morbidity, and mortality. [ncbi.nlm.nih.gov]

A case of pancreatic abscess with pancreaticobiliary fistula manifesting as obstructive jaundice of occult etiology is presented. Diagnosis was made preoperatively by skinny needle percutaneous transhepatic cholangiography. [ncbi.nlm.nih.gov]

Etiology Etiology by source References: [5] [6] [1] [2] [7] [8] [9] [10] [11] [12] Risk factors Clinical features Classic triad of pyogenic liver abscess Fever (with/without chills and rigors) Malaise Right upper quadrant pain (up to 75% of patients) [amboss.com]

Survey Research Expert Houston, Texas Academic Physicians Madison, Wisconsin Clinician Educator New Haven, Connecticut Tenure-Track Assistant or Associate Professor Department of Epidemiology Baltimore, Maryland View all jobs [academic.oup.com]

Epidemiology References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

The purposes of this study were to ascertain the clinical significance of viridans streptococcal bacteremia and to determine the epidemiological, clinical, and microbiological features. [annlabmed.org]

You are (*) If you have selected the “Other” category, please specify which type of user you are: * Email address: * Topic of your comment * Epidemiology data Summary and related texts Related genes Clinical signs Nomenclature and/or coding Your message [orpha.net]

Stimac D, Mikolasevic I, Krznaric-Zrnic I, et al ; Epidemiology of Acute Pancreatitis in the North Adriatic Region of Croatia during the Last Ten Years. Gastroenterol Res Pract. 20132013:956149. doi: 10.1155/2013/956149. Epub 2013 Feb 14. [patient.info]

Corresponding to the lack of pathophysiologic effects of AP per se, pulmonary and renal insufficiencies occur in only 33.3% and 16.7%, respectively, and mortality in these patients is 22.2%. [ncbi.nlm.nih.gov]

This volume summarizes several important updates in abdominal surgery and pathophysiology. [books.google.com]

Pathophysiology ANP is the most severe end of a spectrum of inflammation associated with pancreatitis. Inflammation causes cell death with resultant devitalized tissue, which is likely to become infected. [odlarmed.com]

References: [1] [2] [3] [4] Pathophysiology Sequence of events leading to pancreatitis : Intrapancreatic activation of pancreatic enzymes : secondary to pancreatic ductal outflow obstruction (e.g., gallstones, cystic fibrosis ) or direct injury to pancreatic [amboss.com]

New pathophysiological findings in acute pancreatitis. Chirurgia 2000 ; 71 : 253 –64. ↵ Buter A, Imrie C, Carter C, et al. Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis. [gut.bmj.com]

Also, it is recommended that patients who have a prolonged clinical response are tested repeatedly as a prevention method to avoid the development of an abscess that may rupture. [4] Prevention [ edit ] In some cases, abscesses may be prevented by draining [en.wikipedia.org]

Prevention Draining a pancreatic pseudocyst may help prevent some cases of pancreatic abscess. However, in many cases the disorder is not preventable. [coordinatedhealth.com]

However, in many cases, the disorder is not preventable. Barshak MB. Pancreatic infection. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. [nlm.nih.gov]

Prevention Draining a pancreatic pseudocyst may help prevent some cases of pancreatic abscess. However, in many cases the disorder is not preventable. Images References Barshak MB. Pancreatic infection. In: Bennett JE, Dolin R, Blaser MJ, eds. [ufhealth.org]

Prevention Draining a pancreatic pseudocyst may help prevent some cases of pancreatic abscess. However, in many cases the disorder is not preventable. References Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. [kentuckyonehealth.org]