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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:

Symptoms

Symptoms include:

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:

Blood culture will show high white blood cell count.

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:

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.

Gallery

Digestive system
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Endocrine glands
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).
Endocrine glands
Endocrine glands release hormones (chemical messengers) into the bloodstream to be transported to various organs and tissues throughout the body. For instance, the pancreas secretes insulin, which allows the body to regulate levels of sugar in the blood. The thyroid gets instructions from the pituitary to secrete hormones which determine the rate of metabolism in the body (the more hormone in the bloodstream, the faster the chemical activity; the less hormone, the slower the activity).

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, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 135.

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, eds. Conn's Current Therapy 2022. Philadelphia, PA: Elsevier; 2022:169-176.

Last reviewed October 26, 2021 by Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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