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Pancreas

  • Chapter
Acute Care Surgery

Abstract

You are asked to evaluate a patient who was admitted for alcohol-induced pancreatitis. The patient has had a smoldering course despite aggressive resuscitation and is, currently, febrile and toxic while receiving broad-spectrum antimicrobial therapy. Physical examination demonstrates midepigastric tenderness on moderate palpation. Computed tomography scan findings are consistent for necrotizing pancreatitis. The white blood cell count has increased from 12,000 to 16,000 over the past 48 hours.Which of the following is the most prudent management plan at this time?

  1. (A)

    Continued medical management

  2. (B)

    Peritoneal lavage

  3. (C)

    Computed tomography—directed biopsy of the necrotic tissue for confirmation of infectious etiology

  4. (D)

    Celiotomy

  5. (E)

    Administration of octreotide

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Authors and Affiliations

  1. Department of Surgery/Division of Trauma, University of Medicine and Dentistry of New Jersey at Newark, Newark, NJ, USA

    Juan A. Asensio MD

  2. Department of Surgery, Division of Trauma Surgery and Surgical Critical Care, Los Angeles County and The University of Southern California Medical Center, Los Angeles, CA, USA

    Patrizio Petrone MD

  3. Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    L. D. Britt MD, MPH

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  1. Juan A. Asensio MD
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  2. Patrizio Petrone MD
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  3. L. D. Britt MD, MPH
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Editors and Affiliations

  1. Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA

    L. D. Britt MD, MPH (Brickhouse Professor of Surgery and Chairman) (Brickhouse Professor of Surgery and Chairman)

  2. Department of Surgery, Oregon Health Sciences University, Portland, OR, USA

    Donald D. Trunkey MD (Professor) (Professor)

  3. Emory University School of Medicine, Grady Memorial Hospital, Atlanta, GA, USA

    David V. Feliciano MD (Professor of Surgery, Chief of Surgery) (Professor of Surgery, Chief of Surgery)

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Asensio, J.A., Petrone, P., Britt, L.D. (2007). Pancreas. In: Britt, L.D., Trunkey, D.D., Feliciano, D.V. (eds) Acute Care Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-69012-4_32

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