Nosocomial Abscess

Olson, Mary M.; Allen, Melody O'Connor

doi:10.1001/archsurg.1989.01410030106018

Cited by 12 publications

(2 citation statements)

References 18 publications

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“…Walled-off pancreatic necrosis infection was recognized after a mean of 25 days of observation (range: 20–34 days), in other words, approximately 58 days (range: 47–73 days) after the development of ANP. The most common pathogens cultured from necrotic content in our present study did not differ significantly from those described most recently in the literature [7, 13, 15].…”

Section: Discussionsupporting

confidence: 53%

“…The most common pathogens involved are Escherichia coli , Klebsiella pneumoniae , Enterococcus faecalis , Staphylococcus aureus, Pseudomonas aeruginosa , Proteus mirabilis , and Streptococcus spp. [13, 15]. A previous study reported that the most common complication of asymptomatic WOPN was an infection of the pancreatic necrosis, which was discovered in 7/16 patients (44%) patients, including 7/9 (78%) patients who had become symptomatic [7].…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous regression of asymptomatic walled-off pancreatic necrosis

Jagielski¹,

Smoczyński²,

Studniarek³

et al. 2019

aoms

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IntroductionAsymptomatic walled-off pancreatic necrosis (WOPN) should be treated conservatively, irrespective of the extent and size of the necrosis. The aim of this study was to evaluate the efficacy and safety of a strategy involving the observation of patients with asymptomatic WOPN over a long period of time.Material and methodsThis study involved the retrospective analysis of 368 patients hospitalized in our department between 2010 and 2016, due to acute pancreatitis and its consequences in the form of pancreatic and peripancreatic fluid collection.ResultsWalled-off pancreatic necrosis was identified in 168/368 (46%) patients. 124/168 (74%) patients with WOPN required interventional treatment due to clinical symptoms arising from the presence of the WOPN. Asymptomatic WOPN was identified in 44/168 (26%) patients. The mean observation time of patients with asymptomatic WOPN was 417.02 days (range: 47–1149 days). Only 1 out of the 44 patients (2%) failed to complete the follow-up. Complete regression of WOPN occurred in 30/44 (68%) patients. The presence of symptoms related to WOPN were identified in 13/44 (30%) patients during the observation. The most frequent indication for interventional treatment of WOPN was infection of the pancreatic necrosis, which was identified in 6/13 patients (46%). Altogether, 137/168 (82%) patients with WOPN required interventional treatment.ConclusionsThe majority of patients with WOPN required interventional treatment. This study provided evidence to support the view that careful observation of patients with asymptomatic WOPN is an efficient and safe treatment strategy. Long-term observation of such patients showed that most will experience spontaneous regression of asymptomatic WOPN without any other form of interventional treatment.

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Section: Discussionsupporting

confidence: 53%