Jia YC, Ding YX, Mei WT, Xue ZG, Zheng Z, Qu YX, Li J, Cao F, Li F. Anterior abdominal abscess - a rare manifestation of severe acute pancreatitis: A case report. World J Clin Cases 2021; 9(30): 9218-9227 [PMID: 34786408 DOI: 10.12998/wjcc.v9.i30.9218]
Corresponding Author of This Article
Fei Li, MD, PhD, Chief Doctor, Doctor, Professor, Surgeon, Department of General Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. feili36@ccmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yu-Chen Jia, Yi-Xuan Ding, Wen-Tong Mei, Zhi-Gang Xue, Zhi Zheng, Yuan-Xu Qu, Jia Li, Feng Cao, Fei Li, Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Yu-Chen Jia, Yi-Xuan Ding, Wen-Tong Mei, Zhi-Gang Xue, Zhi Zheng, Yuan-Xu Qu, Jia Li, Feng Cao, Fei Li, Clinical Center for Acute Pancreatitis, Capital Medical University, Beijing 100053, China
Author contributions: Jia YC evaluated the patient and initiated the case report and reviewed the literature and drafted the manuscript; Ding YX, Mei WT, Xue ZG, Zheng Z, and Qu YX consulted the relevant literature and participated in the diagnosis and treatment of patient; Li J, Cao F, and Li F were responsible for formulating the patient’s treatment plan and revising the manuscript; All authors issued final approval for the version to be submitted.
Supported byBeijing Municipal Science and Technology Commission, No. Z171100001017077; Beijing Municipal Science and Technology Commission Clinical Diagnosis and Treatment Technology Research and Demonstration Application Project, No. Z191100006619038; Capital Medical Development and Research Special Project, No. 2020-1-2012; Construction Project of Clinical Advanced subjects of Capital Medical University, No. 1192070312.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei Li, MD, PhD, Chief Doctor, Doctor, Professor, Surgeon, Department of General Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China. feili36@ccmu.edu.cn
Received: May 17, 2021 Peer-review started: May 17, 2021 First decision: June 24, 2021 Revised: July 1, 2021 Accepted: August 27, 2021 Article in press: August 27, 2021 Published online: October 26, 2021 Processing time: 156 Days and 17.5 Hours
Abstract
BACKGROUND
Severe acute pancreatitis (SAP) is a common critical disease of the digestive system. In addition to the clinical manifestations and biochemical changes of acute pancreatitis, SAP is also accompanied by organ failure lasting more than 48 h. SAP is characterized by focal or extensive pancreatic necrosis, hemorrhage and obvious inflammation around the pancreas. The peripancreatic fat space, fascia, mesentery and adjacent organs are often involved. The common local complications include acute peripancreatic fluid collection, acute necrotic collection, pancreatic pseudocyst, walled off necrosis and infected pancreatic necrosis. After reviewing the literature, we found that in very few cases, SAP patients have complications with anterior abdominal wall abscesses.
CASE SUMMARY
We report a 66-year-old Asian male with severe acute pancreatitis who presented with intermittent abdominal pain and an increasing abdominal mass. The abscess spread from the retroperitoneum to the anterior abdominal wall and the right groin. In the described case, drainage tubes were placed in the retroperitoneal and anterior abdominal wall by percutaneous puncture. After a series of symptomatic supportive therapies, the patient was discharged from the hospital with a retroperitoneal drainage tube after the toleration of oral feeding and the improvement of nutritional status.
CONCLUSION
We believe that patients with SAP complicated with anterior abdominal abscess can be treated conservatively to avoid unnecessary exploration or operation.
Core Tip: Severe acute pancreatitis is a common critical disease of the digestive system. Its local complications are pancreatic pseudocyst, walled off necrosis and infected pancreatic necrosis. However, so far, there are few cases of severe acute pancreatitis with anterior abdominal abscess. We report a rare case of anterior abdominal abscess with severe acute pancreatitis. We think that for such cases, conservative treatment can be carried out to avoid unnecessary exploration or operation.
