Bacterial Infection and the Role of Fine Needle Aspiration
There is general agreement among clinicians and pancreatologists that pancreatic infection is the most important causal factor of lethal outcome in human acute pancreatitis today [1–3]. Bacterial contamination of pancreatic necrosis has been demonstrated in 40%–70% of patients suffering from necrotizing pancreatitis [4–8], and it has been shown that the frequency of positive cultures increases directly with the duration and extent of necrosis. The necroses in 24% of patients with necrotizing pancreatitis operated on during the first week after hospitalization showed bacterial contamination. This percentage increased to 36% in the second week and to 72% in the third week; thereafter a decrease was found to 32% . Bacterial contamination of pancreatic necrosis occurs early and frequently, as verified by Bassi in a similar study and by Gerzof with the aid of computed tomography (CT)-guided fine needle aspiration and Gram staining [5, 6].
KeywordsAcute Pancreatitis Fine Needle Aspiration Acute pancreatitIs Severe Acute Pancreatitis Pancreatic Necrosis
Unable to display preview. Download preview PDF.
- 3.Beger HG, Biichler M (1986) Decision-making in surgical treatment of acute pancreatitis: operative or conservative management of necrotizing pancreatitis? Theor Surg 1:61–68Google Scholar
- 6.Bassi C, Falconi M, Girelli R, Nifosi F, Elio A, Martini N, Pederzoli P (1989) Microbiological findings in severe pancreatitis. Surg Res Comm 5:1–4Google Scholar
- 15.van Sonnenberg E, Wing VW, Casola G, Nakamoto SK, Mueller PR, Ferrucci JT, Halasz NA, Simeone JF (1984) Temporizing effect of percutaneous drainage of complicated abscesses in critically ill patients. AJR 142:821–826Google Scholar
- 16.Warshaw AL (1974) Inflammatory masses following acute pancreatitis. Surg Gynecol Obstet 139:69–81Google Scholar
- 18.Lange JF, van Gool J, Tytgat GNJ (1985) The protective effect of a reduction in intestinal flora on mortality of acute haemorrhagic pancreatitis in the rat. Hepatogastroenterology 34:28–30Google Scholar
- 20.Büchler M (1991) Objectivation of the severity of acute pancreatitis. Hepato- Gastroenterol 38:101–108Google Scholar
- 23.Gross V, Schölmerich J, Leser HG (1989) Wertigkeit von Leukozytenelastase, C-reaktiven Protein und Proteaseninhibitoren für die Prognose der akuten Pankreatitis. Klin Wochenschr 67:237 (abstract)Google Scholar
- 26.Balhazar EJ (1989) CT diagnosis and staging of acute pancreatitis. Rad Clin North Am 27:19–37Google Scholar
- 28.Gerzof SG, Banks PA, Robbins AH (1984) Role of guided percutaneous aspiration in early diagnosis of pancreatic sepsis. Dig Dis Sci 29:950 (abstract)Google Scholar
- 30.Beger HG, Uhl W (1990) Severe acute pancreatitis. II: The surgical approach. Clin Int Care 1:223–227Google Scholar