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Digestive Diseases and Sciences

, Volume 59, Issue 9, pp 2069–2075 | Cite as

Getting the Dead Out: Modern Treatment Strategies for Necrotizing Pancreatitis

  • Monica M. Dua
  • David J. Worhunsky
  • Sabina Amin
  • John D. Louie
  • Walter G. Park
  • George Triadafilopoulos
  • Brendan C. VisserEmail author
Stanford Multidisciplinary Seminars

Case Presentation and Evolution

A 21-year-old male was brought to the emergency department with severe abdominal pain and vomiting. Low-grade fever and epigastric tenderness were noted on examination; laboratory values included a WBC of 11 K/μL and elevated amylase and lipase to 1,593 and >3,000 U/L, respectively. A CT scan was interpreted as showing an enlarged and ill-defined pancreas with heterogeneous parenchymal enhancement, consistent with pancreatitis. Several peripancreatic fluid collections extended bilaterally to the para-renal spaces, left para-colic gutter, and pelvis (Fig.  1). An ultrasound of the gallbladder was normal with no gallstones visualized. The patient had no other contributory past medical or social history. He was admitted to the medical service and initially developed a systemic inflammatory response (SIRS) to his idiopathic pancreatitis, with fever, tachycardia, and a white count peak to 16 K/μL. After several days of intravenous fluid resuscitation and...

Keywords

Pancreatitis Acute Pancreatitis Pancreatic Necrosis Necrotizing Pancreatitis Infected Pancreatic Necrosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Monica M. Dua
    • 1
  • David J. Worhunsky
    • 1
  • Sabina Amin
    • 2
  • John D. Louie
    • 2
  • Walter G. Park
    • 3
  • George Triadafilopoulos
    • 3
  • Brendan C. Visser
    • 1
    Email author
  1. 1.Division of Surgical Oncology, Department of SurgeryStanford University Medical CenterStanfordUSA
  2. 2.Department of RadiologyStanford University Medical CenterStanfordUSA
  3. 3.Department of MedicineStanford University Medical CenterStanfordUSA

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