Abstract
The most significant change in the clinical course of acute pancreatitis over the past decades has undoubtedly been the decrease in mortality. Almost all deaths caused by acute pancreatitis are observed in patients with severe acute pancreatitis. Today, there is no doubt that pancreatic infection is the major risk factor in necrotizing pancreatitis with regard to morbidity and mortality in the later phase of the disease (Beger et al. 1986; Buchler et al. 2000; Werner et al. 2005). While pancreatic necrosis develops within the first week, superinfection of pancreatic and peripancreatic necrosis is usually observed 2-3 weeks after the onset of the disease (Beger et al. 1986; Werner et al. 2003). The frequency of infection correlates with the extent of necrosis. The profile of the organisms suggests an origin in the gastrointestinal tract. The ways in which microorganisms reach the pancreas include transperitoneal spread and the spread along the pancreatic duct ascending from the duodenum or descending from the bile duct, as well as via lymph or the bloodstream.
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Werner, J., Conlon, K.C.P., van Santvoort, H.C., Verbeke, C.S., Rahman, S.H. (2010). Antibiotic Prophylaxis in Acute Severe Pancreatitis: Should We Have a Further Study?. In: Johnson, C., Imrie, C. (eds) Pancreatic Disease. Springer, London. https://doi.org/10.1007/978-1-84882-118-7_2
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DOI: https://doi.org/10.1007/978-1-84882-118-7_2
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