Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/20021
Title: Pancreatic Necrosis and Gas in the Retroperitoneum: Treatment with Antibiotics Alone
Authors: RASSLAN, RobertoNOVO, Fernando da Costa FerreiraROCHA, Marcelo CristianoBITRAN, AlbertoROCHA, Manoel de SouzaBERNINI, Celso de OliveiraRASSLAN, SamirUTIYAMA, Edivaldo Massazo
Citation: CLINICS, v.72, n.2, p.87-94, 2017
Abstract: OBJECTIVE: To present our experience in the management of patients with infected pancreatic necrosis without drainage. METHODS: The records of patients with pancreatic necrosis admitted to our facility from 2011 to 2015 were retrospectively reviewed. RESULTS: We identified 61 patients with pancreatic necrosis. Six patients with pancreatic necrosis and gas in the retroperitoneum were treated exclusively with clinical support without any type of drainage. Only 2 patients had an APACHE II score>8. The first computed tomography scan revealed the presence of gas in 5 patients. The Balthazar computed tomography severity index score was >9 in 5 of the 6 patients. All patients were treated with antibiotics for at least 3 weeks. Blood cultures were positive in only 2 patients. Parenteral nutrition was not used in these patients. The length of hospital stay exceeded three weeks for 5 patients; 3 patients had to be readmitted. A cholecystectomy was performed after necrosis was completely resolved; pancreatitis recurred in 2 patients before the operation. No patients died. CONCLUSIONS: In selected patients, infected pancreatic necrosis (gas in the retroperitoneum) can be treated without percutaneous drainage or any additional surgical intervention. Intervention procedures should be performed for patients who exhibit clinical and laboratory deterioration.
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Artigos e Materiais de Revistas Científicas - FM/MCG
Departamento de Cirurgia - FM/MCG

Artigos e Materiais de Revistas Científicas - FM/MDR
Departamento de Radiologia - FM/MDR

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InRad
Instituto de Radiologia - HC/InRad

Artigos e Materiais de Revistas Científicas - LIM/62
LIM/62 - Laboratório de Fisiopatologia Cirúrgica


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