Indolent Presentation of Pancreatic Abscess: Experience With 100 Cases
Aaron S. Fink, Jonathan R. Hiatt, Henry A. Pitt, Robert S. Bennion, Luis R. Desouza, Robin D. McCoy, James H. Meyer, Jesse E. Thompson, Joseph L. Webster, Samuel E. Wilson
One hundred cases of pancreatic abscess were identified at five hospitals affiliated with UCLA between 1973 and 1985. Patients were included if a pancreatic mass or phlegmon followed an episode of pancreatitis, if the clinical impression was pancreatic abscess, and if drainage cultures were positive. Less than three Ranson's signs were present on admission in 72% of patients. The admission temperature was less than 38.3°C in 71% of patients, and 27% of patients never had a fever. Abdominal tenderness was absent in 40% of patients. The admission amylase concentrations and white blood cell counts were normal in 36% and 23% of patients, respectively. Extensive débridement, external drainage, and a low threshold for reoperation were the mainstays of surgical therapy. Twenty patients (20%) died, but Ranson's signs did not predict outcome. Pancreatic abscess may have an insidious presentation. A high index of suspicion, early computed tomographic scanning, and diagnostic needle aspiration may be necessary to establish this diagnosis.
Archives of surgery
https://doi.org/10.1001/archsurg.1988.01400330043006
10.1001/archsurg.1988.01400330043006
Dive into the research topics of 'Indolent Presentation of Pancreatic Abscess: Experience With 100 Cases'. Together they form a unique fingerprint.
Abscess Medicine & Life Sciences 100%
Drainage Medicine & Life Sciences 26%
Amylases Medicine & Life Sciences 16%
Leukocyte Count Medicine & Life Sciences 14%
Reoperation Medicine & Life Sciences 14%
Needles Medicine & Life Sciences 13%
Fever Medicine & Life Sciences 11%
Fink, A. S., Hiatt, J. R., Pitt, H. A., Bennion, R. S., Desouza, L. R., McCoy, R. D., Meyer, J. H., Thompson, J. E., Webster, J. L., & Wilson, S. E. (1988). Indolent Presentation of Pancreatic Abscess: Experience With 100 Cases. Archives of surgery, 123(9), 1067-1072. https://doi.org/10.1001/archsurg.1988.01400330043006
Indolent Presentation of Pancreatic Abscess : Experience With 100 Cases. / Fink, Aaron S.; Hiatt, Jonathan R.; Pitt, Henry A. et al.
In: Archives of surgery, Vol. 123, No. 9, 09.1988, p. 1067-1072.
Fink, AS, Hiatt, JR, Pitt, HA, Bennion, RS, Desouza, LR, McCoy, RD, Meyer, JH, Thompson, JE, Webster, JL & Wilson, SE 1988, 'Indolent Presentation of Pancreatic Abscess: Experience With 100 Cases', Archives of surgery, vol. 123, no. 9, pp. 1067-1072. https://doi.org/10.1001/archsurg.1988.01400330043006
Fink AS, Hiatt JR, Pitt HA, Bennion RS, Desouza LR, McCoy RD et al. Indolent Presentation of Pancreatic Abscess: Experience With 100 Cases. Archives of surgery. 1988 Sep;123(9):1067-1072. doi: 10.1001/archsurg.1988.01400330043006
Fink, Aaron S. ; Hiatt, Jonathan R. ; Pitt, Henry A. et al. / Indolent Presentation of Pancreatic Abscess : Experience With 100 Cases. In: Archives of surgery. 1988 ; Vol. 123, No. 9. pp. 1067-1072.
@article{86aac3cf772a409181293aa53c6b9a21,
title = "Indolent Presentation of Pancreatic Abscess: Experience With 100 Cases",
abstract = "One hundred cases of pancreatic abscess were identified at five hospitals affiliated with UCLA between 1973 and 1985. Patients were included if a pancreatic mass or phlegmon followed an episode of pancreatitis, if the clinical impression was pancreatic abscess, and if drainage cultures were positive. Less than three Ranson's signs were present on admission in 72% of patients. The admission temperature was less than 38.3°C in 71% of patients, and 27% of patients never had a fever. Abdominal tenderness was absent in 40% of patients. The admission amylase concentrations and white blood cell counts were normal in 36% and 23% of patients, respectively. Extensive d{\'e}bridement, external drainage, and a low threshold for reoperation were the mainstays of surgical therapy. Twenty patients (20%) died, but Ranson's signs did not predict outcome. Pancreatic abscess may have an insidious presentation. A high index of suspicion, early computed tomographic scanning, and diagnostic needle aspiration may be necessary to establish this diagnosis.",
author = "Fink, {Aaron S.} and Hiatt, {Jonathan R.} and Pitt, {Henry A.} and Bennion, {Robert S.} and Desouza, {Luis R.} and McCoy, {Robin D.} and Meyer, {James H.} and Thompson, {Jesse E.} and Webster, {Joseph L.} and Wilson, {Samuel E.}",
doi = "10.1001/archsurg.1988.01400330043006",
journal = "JAMA Surgery",
T1 - Indolent Presentation of Pancreatic Abscess
T2 - Experience With 100 Cases
AU - Fink, Aaron S.
AU - Hiatt, Jonathan R.
AU - Pitt, Henry A.
AU - Bennion, Robert S.
AU - Desouza, Luis R.
AU - McCoy, Robin D.
AU - Meyer, James H.
AU - Thompson, Jesse E.
AU - Webster, Joseph L.
AU - Wilson, Samuel E.
N2 - One hundred cases of pancreatic abscess were identified at five hospitals affiliated with UCLA between 1973 and 1985. Patients were included if a pancreatic mass or phlegmon followed an episode of pancreatitis, if the clinical impression was pancreatic abscess, and if drainage cultures were positive. Less than three Ranson's signs were present on admission in 72% of patients. The admission temperature was less than 38.3°C in 71% of patients, and 27% of patients never had a fever. Abdominal tenderness was absent in 40% of patients. The admission amylase concentrations and white blood cell counts were normal in 36% and 23% of patients, respectively. Extensive débridement, external drainage, and a low threshold for reoperation were the mainstays of surgical therapy. Twenty patients (20%) died, but Ranson's signs did not predict outcome. Pancreatic abscess may have an insidious presentation. A high index of suspicion, early computed tomographic scanning, and diagnostic needle aspiration may be necessary to establish this diagnosis.
AB - One hundred cases of pancreatic abscess were identified at five hospitals affiliated with UCLA between 1973 and 1985. Patients were included if a pancreatic mass or phlegmon followed an episode of pancreatitis, if the clinical impression was pancreatic abscess, and if drainage cultures were positive. Less than three Ranson's signs were present on admission in 72% of patients. The admission temperature was less than 38.3°C in 71% of patients, and 27% of patients never had a fever. Abdominal tenderness was absent in 40% of patients. The admission amylase concentrations and white blood cell counts were normal in 36% and 23% of patients, respectively. Extensive débridement, external drainage, and a low threshold for reoperation were the mainstays of surgical therapy. Twenty patients (20%) died, but Ranson's signs did not predict outcome. Pancreatic abscess may have an insidious presentation. A high index of suspicion, early computed tomographic scanning, and diagnostic needle aspiration may be necessary to establish this diagnosis.
U2 - 10.1001/archsurg.1988.01400330043006
DO - 10.1001/archsurg.1988.01400330043006
JO - JAMA Surgery
JF - JAMA Surgery