Pancreatic necrosis can often be accompanied not only by profuse purulent complications, but also by the dysfunction of other digestive organs and various infections. The frequency of infectious complications with pancreatic necrosis is observed in every third patient. The probability of their appearance directly depends on the area of the pancreonecrosis of the gland. The risk of infection is a sharp increase in mortality among patients.
Based on long-term studies of the emergence of infectious complications in patients with pancreatic necrosis, it was possible to establish that the most dangerous period is the first three weeks of the disease:
- , the first week - the risk of infection is 25%;
- second week - infection risk 45%;
- third week - 60% infection risk.
After the third week, the risk of infection is dramatically reduced and by the fifth week is becoming minimal.
There are several options for further development of infected pancreatonecrosis, but the most dangerous man
ifestations are abdominal sepsis and peritonitis. Necrosis of the pancreas can lead to complications in the form of peritonitis in 4% of cases.
Infection is often a polymicrobial and is largely determined by the intestinal microflora. But a severe monomicrobial complication can occur no later than the first week of pancreatic necrosis. Therefore, the microbial background is so diverse and variable in the infected form of pancreatic necrosis. The main causative agents of infection of the gland are enterococci, Clostridium spp, Bacteroides spp, Pseudomonas aeruginosa, Proteus spp, Enterobacter spp, Klebsiella spp and Escherichia coli. Against the background of infected pancreatonecrosis, purulent complications are more likely to develop closer to the second or fourth week from the onset of the disease. Signs of this condition will be tachycardia, chills, sweating, fever.
To prevent purulent and infected complications of pancreatic necrosis, patients are prescribed immunosupplemental therapy with immunoglobulin and hyperimmune plasmas. On the fourth day, according to the results of the patient's immunogram, treatment can be supplemented with immunocorrectors: polyoxidonium, T-activin and myelopid.
Another common complication of pancreatic necrosis is the appearance of destructive complications, for the treatment of which surgical methods are used, the purpose of which is to suck out the effusion in the abdominal cavity and establish drainage.