This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
A patient with necrotizing pancreatitis undergoes CT guided aspiration, which results in growth of E-coli on culture. The most appropriate treatment is: 
Select and explain. 
A. Culture appropriate antibiotic therapy, B. ERCP with sphincterotomy, C. CT guided placement of drain(s), D. Exploratory laparotomy
D: Exploratory laparotomy
Answer: D: Exploratory laparotomy 
Explanation: Exploratory laparotomy The presence of secondary pancreatic infection suspected in patients whose systemic inflammatory response (fever, WBC count or organ dysfunction) fails to resolve, CT-guided aspiration of fluid from pancreatic bed for performance of Gram's stain & culture analysis is of critical impoance. A positive is Gram's stain or culture or identification of gas within pancreas on CT-scan, mandate operative intervention.