Pancreatic abscess

A pancreatic abscess is an area filled with pus within the pancreas.

Causes

Pancreatic abscesses develop in people who have:

Pancreatic pseudocysts
Severe pancreatitis that becomes infected

Symptoms

Symptoms include:

Abdominal mass
Abdominal pain
Chills
Fever
Inability to eat
Nausea and vomiting

Exams and Tests

Most people with pancreatic abscesses have had pancreatitis. However, the complication often takes 7 or more days to develop.

Signs of an abscess can be seen on:

CT scan of the abdomen
MRI of the abdomen
Ultrasound of the abdomen

Blood culture will show high white blood cell count.

Treatment

It may be possible to drain the abscess through the skin (percutaneous). Abscess drainage can be done through an endoscope using endoscopic ultrasound (EUS) in some cases. Surgery to drain the abscess and remove dead tissue is often needed.

Prognosis

How well a person does depends on how severe the infection is. The death rate from undrained pancreatic abscesses is very high.

Possible Complications

Complications may include:

Multiple abscesses
Sepsis

When to Contact a Medical Professional

Call your health care provider if you have:

Abdominal pain with fever
Other signs of a pancreatic abscess, especially if you have recently had a pancreatic pseudocyst or pancreatitis

Prevention

Draining a pancreatic pseudocyst may help prevent some cases of pancreatic abscess. However, in many cases, the disorder is not preventable.

References

Barshak MB. Pancreatic infection.In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 76.

Ferreira LE, Baron TH. Endoscopic treatment of pancreatic disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 61.