Emphysematous Pancreatitis: An Uncommon Cause of Intraperitoneal and Retroperitoneal Gas

Mohamed Ali Chaouch1, Ibtissem Bouasker1, Wael Ferjaoui1*, Aziz Daghmouri2, Mohamed Wejih Dougaz1, Hichem Jerraya1 and Ramzi Nouira1

1Department of Surgery, Charles Nicolle Hospital, Tunisia
2Department of Intensive Care, Charles Nicolle Hospital, Tunisia

^*Correspondance to: Wael Ferjaoui 

 PDF  Full Text DOI: 10.25107/2474-1647.2798

Abstract

Acute Pancreatitis (AP) is a frequent abdominal emergency. Emphysematous Pancreatitis (EP) is an uncommon form of AP characterized by the destruction of the pancreatic parenchyma with diffuse air infiltration. We present the case of a 73-year-old woman with acute epigastric pain and epigastric tenderness. Lab workup showed elevated serum lipase, high C-reactive protein, and renal failure. Abdominal CT-scan was consistent with EP showing a marked distortion of the pancreas, a large amount of gas either in the pancreatic parenchyma as intraperitoneal and retroperitoneal spaces with. Intraoperative findings revealed diffuse necrosis of the pancreas. No digestive tract perforation was found. A cholecystectomy, an extensive pancreatic necrosectomy combined with open packing was performed. Escherichia coli was isolated from the peritoneal fluid. The patient died after four days of surgery. EP is a severe life-threatening disease. Clinical symptoms are nonspecific, and diagnosis is often difficult. Abdominal CT-scan is the diagnostic imaging modality of choice. Conservative management strategy based on percutaneous drainage or medical management alone seems to be correlated with decreased mortality rate compared with surgery.

Keywords

Emphysematous Pancreatitis; Tomography; Necrotizing pancreatitis

Cite the article

Chaouch MA, Bouasker I, Ferjaoui W, Daghmouri A, Wejih Dougaz M, Jerraya H, et al. Emphysematous Pancreatitis: An Uncommon Cause of Intraperitoneal and Retroperitoneal Gas. Clin Surg. 2020; 5: 2798..