Pancreatic abscess
A pancreatic abscess is an area filled with pus within the pancreas.
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 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).
The pancreas is an elongated, tapered gland that is located behind the stomach and secretes digestive enzymes and the hormones insulin and glucagon.
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.
Version Info
Last reviewed on: 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.
