An abscess of the pancreas is the purulent fusion of the organ tissues and their accumulation. It develops usually against a background of severe pancreatitis( except edematous form), and the most common cause is pancreatitis of alcoholic origin. But there are cases of development of pancreatic abscess as a result of secondary infection pseudocysts.
The hearth of appearance is often a glandular bag, where pancreas secretions and dying cells accumulate. But cases of a multiplicity of foci of inflammation are not uncommon.
The causative agent of the process most often become: staphylococci, streptococci, E. coli and some varieties of anaerobic microorganisms.
Clinic and symptoms of pancreatic abscess
For the manifestations of this disease, it is characteristic that they arise in most cases after 1-2, and sometimes 3 weeks after a serious attack of pancreatitis.
After the symptoms of pancreatitis stop worrying, the patient may experience fever and resuscitation of abdominal pain accompanied by increased muscle tone in this area. Appetite worsens, nausea and even vomiting may resume.
Like most other types of inflammation, the pancreatic abscess manifests itself by symptoms such as a rise in body temperature( sometimes reaching 39 ° C, and sometimes even above 40 ° C) and accompanying chills.
Characteristic are general malaise, shortness of breath, sweating, problems with arterial pressure, heart rhythm( tachycardia) begin.
Pain in the abdomen may not be very strong, especially at the beginning.
Based on the results of the examination and questioning, the doctor may presume the development of an abscess of the pancreas. For the purpose of clarification:
- palpation of the abdominal cavity, where muscle tension is determined, and sometimes a characteristic tumor;
- urine analysis and biochemical blood test to clarify the level of leukocytes, the content of amylase;
- to clarify the diagnosis and optimize the selection of medications is done by sowing blood.
An x-ray or ultrasound examination of the abdominal cavity may also be prescribed: a pancreatic abscess on the radiograph is similar to a cluster of blisters located behind the stomach and even causing some displacement of the stomach forward. Sometimes there is a shift and squeezing of some other adjacent internal organs, as well as the rise of the left dome of the diaphragm.
Treatment of pancreatic abscess
The only effective treatment for this disease is surgical intervention - drainage accompanied by antibiotic therapy. It is also necessary to clean all necrotic areas and carefully inspect the entire contiguous area for possible new centers of inflammation and the presence of abscesses.
Without the timely withdrawal of purulent masses, the abscess will inevitably break through into the adjacent internal organs: in the bronchus, duodenum, stomach, pleural cavity, bile duct and even outwards.
Purulent fusion of the tissues of organs can lead to the formation of fistulas, and as a result - new abscesses. This causes a continuous sepsis, significantly worsening the general condition of the patient and reducing his chances of recovery. Damage to the wall of the retroperitoneal artery can lead to dangerous internal bleeding.
Abscess is one of the most dangerous among pancreatic diseases. The chances of recovery directly depend on the speed of treatment and surgical intervention, but even in this case, the mortality rate is at least one third of cases.