Abstract:
Introduction:
Pancreatic pseudocyst (PP) is one of the
evolutionary complications of severe
acute pancreatitis. The reported
incidence is 2-15%, PP suppuration is
reported in 1.6 - 4.5%. The surgical
approach to suppurative PP remains a
current issue. Purpose:
Description of the clinical case illustrating
a variant of the surgical attitude in
suppurative PP. Material and methods:
Woman 72 years old, with a history of breast CR
T3N1M0 operated,
state after 2 courses of chemotherapy,
hypertension gr. III, ischemic heart disease, angina
pectoris IC II NIHA, is hospitalized primarily for
severe acute pancreatitis after chemotherapy.
Treatment with evolution in PP. Readmitted over 3
months for severe epigastric pain, multiple
vomiting and fever -38˚ C. Results:
Investigations: Le - 18.0x10 9 / l, blood amylase -
116 u / e, urine amylase -1876 u / e. USG - dilimited
liquid formation with a diameter of 15 cm with
inhomogeneous content, located in the body and
pancreatic tail. Surgical treatment: paracostal
laparotomy, opening and
evacuation of pus and necrotic masses, bilateral
bilumen drainage. Postoperative: by fractional
lavage drains with antiseptic and anti-enzyme
solutions. The drain on the right removed after 16
days, on the left - 45 days. USG control did not
report any remainding cavities. In evolution -
insulin-dependent secondary diabetes. Conclusions:
USG has a major important in the
diagnosis and selection of the approach to
the patient with suppurative pancreatic
pseudocyst. Regardless of the
contemporary arsenal of minimally
invasive treatment methods, traditional
surgery has indications in suppurated PP
in correlation with the size, location of the
formation and the presence of necrotic
tissue content.
