Local complications of acute pancreatitis

Abstract

Acute pancreatitis is seen commonly on the surgical take. It can be complicated by the development of pseudocysts and necrosis. This review discusses each of these in turn and outlines the different management strategies now on offer.

Review of Current Evidence in Acute Pancreatitis

“…Its management is similar to that in the case of infected PAN [104]. Other local complications include pancreatic fistula, pseudocyst or pancreatocutaneous fistula, pseudo-aneurysm of the pancreatic artery, portal vein thrombosis, and superior mesenteric (manifested by ascites of recent onset) and/or splenic aneurysm which may occur several weeks after hospitalization, and should be detected and treated in an adequate and timely manner [69,99]. Hemorrhage of pancreatic bed or retroperitoneum should be managed according to the etiology.…”

“…These complications, by themselves, do not define the severity of AP. They are described by CT on the basis of their location (pancreatic, peri-pancreatic, or other), content (liquid, solid, or gas), and thickness of the wall (thin or thick) [99]. Currently, abdominal CT serves as a non-invasive diagnostic tool for the detection of collections [54,100].…”

“…If the pseudocyst is asymptomatic, it is managed conservatively, since it resolves spontaneously in >50% of the cases. If the pseudocyst is symptomatic, it becomes infected or exhibits increased size on consecutive images, and should be intervened mainly with endoscopic techniques [99,102,103]. 4.…”

Review of Current Evidence in the etiopathogenesis, epidemiology, diagnosis and management of acute pancreatitis

“…By themselves, they do not define AP severity. They are described by CT based on location (pancreatic, peripancreatic or other), the content (liquid, solid or gas) and thickness of the wall (thin or thick) [105]. Currently, abdominal CT is a non-invasive diagnostic tool to detect collections [56,106].…”

“…If it is asymptomatic, it is managed conservatively, since > 50% resolve spontaneously. If it is symptomatic, it becomes infected or increases in size on serial images, should be intervened mainly with endoscopic techniques [105,109,110]. 4.…”