Pancreatic Abscess and Infected Pancreatic Necrosis: Different Local Septic Complications in Acute Pancreatitis

Abstract

Most publications consider pancreatic abscess a rare complication in acute pancreatitis, occurring with a frequency of only 1%–4% [1–7]. Only 103 cases are described in the literature up to 1967 [8]. Today, however, pancreatic abscess is gaining increasing importance. Although many authors still underestimate its significance, it is now acknowledged to be one of the most dangerous complications [9] and the commonest cause of death in acute pancreatitis [10]. It is therefore necessary to develop better methods for the prevention, early diagnosis and therapeutic management of this complication. This in turn raises the problem that no generally accepted definition of pancreatic abscess exists to date [11]. Where some authors think that only localized collection of pus in the pancreatic or peripancreatic region constitutes an abscess, others define it as any kind of local septic complication in acute pancreatitis, including even bacterially contaminated necrosis without any significant pus formation [10, 12].