Management of Complications associated with Acute Pancreatitis

In this article, we will discuss the Management of Complications associated with Acute Pancreatitis. So, let’s get started.

Management

Patients who have developed necrotising pancreatitis (fever, leukocytosis) require urgent surgical debridement of the pancreas, followed by percutaneous aspiration. The aspirated material is stained with Gram’s stain and sent for culture. This may be associated with left sided pleural effusion which should be aspirated.

Pancreatic abscess is treated by antibiotics and fine needle aspiration. Surgical drainage is required when percutaneous drainage of pus is not helpful.

Pancreatic pseudocysts are treated by drainage into the stomach or duodenum. This is usually done after at least 6 weeks, once a pseudocapsule is formed, using open surgery or endoscopic method.

Pancreatic ascites is exudative (protein >2.5 g/L) and has high serum amylase levels (>1000 U/dl). Medical treatment includes nasogastric aspiration, total parenteral nutrition and octreotide therapy. As it occurs due to leakage from the cyst or duct, hence, surgery may be needed to correct this leakage.

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