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Severe acute pancreatitis – managing complications using a combination of minimally invasive approaches


Authors: L. Doležalová 1;  P. Volšanský 1;  F. Neumann 1;  L. Denemark 2
Authors‘ workplace: Oblastní nemocnice Kolín, a. s., Endoskopické centrum, primář: MUDr. P. Volšanský 1;  Oblastní nemocnice Kolín, a. s., Chirurgie, primář: MUDr. L. Denemark 2
Published in: Rozhl. Chir., 2014, roč. 93, č. 4, s. 216-219.
Category: Case Reports

Overview

In this case report, we describe the case of a 30-year-old obese patient with severe acute pancreatitis complicated during hospitalization by the development of infected necrosis, a pseudocyst and an abscess. We demonstrate a possible solution to these complications using a combination of minimally invasive approaches. The contribution of this case report resides in that it presents a combination of the percutaneous approach and the endosonographic approach in the treatment of pancreatic necrosis. We believe that in such an extensive necrosis of the pancreas as is described in our case, this combined approach is optimal. The condition for implementing such a procedure is a well-staffed and technically equipped workplace.

Key words:
acute pancreatitis – pancreatic necrosis – pseudocyst – video-assisted endoscopic necrosectomy – pseudocystogastrostomy


Sources

1. Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology Guideline: Management of Acute Pancreatitis. The American Journal of gastroenterology 2013;9:1400-1413.

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3. Kostka R. Možnosti chirurgické léčby nekrotizující pankreatitidy [on line]. Dostupný z www: http://www.hpb.cz/index.php? pId=07-1-05.

4. Szentkereszty Z, Kotán R, Sápy P. The role of percutaneous drainage in the treatment of severe acute pancreatitis on the bases of the modified Atlanta Classification [on line]. Dostupný z www: http://bib.irb.hr/datoteka/574951.Acute_Pancreatitis.pdf.

5. Kašpar M, Horák M. Perkutánní drenáž – možnost léčby akutní pankreatitidy [on line]. Dostupný z www: http://www.zdravky. cz/zpravodajstvi/lekarske-listy-plus/perkutanni-drenaz-moznost-lecby-akutni-pankreatitidy.

6. Tenner S, Steinberg WM. Acute pancreatitis. In: Sleisenger and Fordtranęs. Gastrointestinal and liver disease. Ninth edition. Canada, Saunders 2010:959–983.

7. Ferreira LE, Baron TH. Endoscopic treatment of pancreatic disease. In: Sleisenger and Fordtranęs. Gastrointestinal and liver disease. Ninth edition. Canada, Saunders 2010:1035–1038.

8. Krška Z. Akutní pankreatitida – komplexní problematika. Rozhl Chir 2012;12:692 – 696.

9. Špičák J. Akutní pankreatitida. Praha, Grada 2005.

Labels
Surgery Orthopaedics Trauma surgery
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