Acute suppuration of the pancreatic duct in a patient with tropical pancreatitis.

Case Reports in Gastroenterology
Liliane S DeebC S Pitchumoni

Abstract

Pancreatic sepsis secondary to infected necrosis, pseudocyst, or pancreatic abscess is a well-known clinical entity. Acute suppuration of the pancreatic duct (ASPD) in the setting of chronic calcific pancreatitis and pancreatic ductal obstruction with septicemia is a rare complication that is seldom reported. It is our aim to report a case of ASPD with Klebsiella ornithinolytica, in the absence of pancreatic abscess or infected necrosis. A 46-year-old Asian-Indian man with chronic tropical pancreatitis who was admitted with recurrent epigastric pain that rapidly evolved into septic shock. A CT scan of abdomen revealed a dilated pancreatic duct with a large calculus. Broad-spectrum antibiotics, vasopressors and activated recombinant protein C were initiated. Emergency ERCP showed the papilla of Vater spontaneously expelling pus. Probing and stenting was instantly performed until pus drainage ceased. Repeat CT scan confirmed the absence of pancreatic necrosis or fluid collection, and decreasing ductal dilatation. Dramatic clinical improvement was observed within 36 hours after intervention. Blood cultures grew Klebsiella ornithinolytica. The patient completed his antibiotic course and was discharged. ASPD without pancreatic absce...Continue Reading

References

Mar 1, 1995·Gastrointestinal Endoscopy·D S Weinman
Jan 28, 1998·International Journal of Pancreatology : Official Journal of the International Association of Pancreatology·F MarottaG Barbi
Mar 19, 2004·Pancreas·Danuta KruszewskaStefan G Pierzynowski
Jul 27, 2006·Pancreas·Raffaele PezzilliRoberto Corinaldesi

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Citations

Apr 1, 2014·Scandinavian Journal of Infectious Diseases·Kerry O ClevelandMichael S Gelfand
Feb 18, 2015·Case Reports in Medicine·Eisha WaliClifford D Packer
May 2, 2017·Journal of Surgical Case Reports·Bapuji S GedamPrasad Y Bansod
Feb 22, 2018·Clinical Journal of Gastroenterology·Ryoko ShimizuguchiKazuro Chiba
Nov 4, 2016·ACG Case Reports Journal·Theodore TollivoroCraig Munroe
Feb 4, 2016·Journal of Gastroenterology and Hepatology·Hiromu KondoTakashi Joh
Dec 4, 2020·Endoscopy International Open·Ryoko ShimizuguchiKazuro Chiba

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