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Pancreatic abscess

Definition

A pancreatic abscess is an area filled with pus within the pancreas.

Causes

Pancreatic abscesses develop in people who have:

• Pancreatic pseudocysts

• Severe pancreatitis that becomes infected

Symptoms

Symptoms include:

• Abdominal mass

• Abdominal pain

• Chills

• Fever

• Inability to eat

• Nausea and vomiting

Exams and Tests

Most people with pancreatic abscesses have had pancreatitis. However, the complication often takes 7 or more days to develop.

Signs of an abscess can be seen on:

• CT scan of the abdomen

• MRI of the abdomen

• Ultrasound of the abdomen

Blood tests will show high white blood cell count. A blood culture may grow bacteria.

Treatment

It may be possible to drain the abscess through the skin (percutaneous). Abscess drainage can be done through an endoscope using endoscopic ultrasound (EUS) in some cases. Surgery to drain the abscess and remove dead tissue is often needed.

Outlook (Prognosis)

How well a person does depends on how severe the infection is. The death rate from undrained pancreatic abscesses is very high.

Possible Complications

Complications may include:

• Multiple abscesses

• Sepsis

When to Contact a Medical Professional

Contact your health care provider if you have:

• Abdominal pain with fever

• Other signs of a pancreatic abscess, especially if you have recently had a pancreatic pseudocyst or pancreatitis

Prevention

Draining a pancreatic pseudocyst may help prevent some cases of pancreatic abscess. However, in many cases, the disorder is not preventable.

References

Barshak MB. Pancreatic infection. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 76.

Forsmark CE. Pancreatitis. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 130.

Law R, Baron TH. Endoscopic treatment of pancreatic disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 61.

Van Buren G, Fisher WE. Acute and chronic pancreatitis. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2024. Philadelphia, PA: Elsevier; 2024:175-182.

Review Date: 12/31/2023

Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Aria - Jefferson Health Torresdale, Jefferson Digestive Diseases Network, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.