What is the treatment of infected necrosis or a pancreatic abscess?
Sterile pancreatic necrosis is best left alone. For infected pancreatic necrosis, or a pancreatic abscess, aspiration of some of the infected fluid or pus with a fine needle under ultrasound or CT guidance is usually the first step. Microbiological testing of the fluid can tell what bacteria are present in it. After this, the treatment may involve placing a tube drain in the infected fluid to drain it to the exterior. If that does not suffice then an operation to remove the dead pancreatic tissue may be considered. This is called a Necrosectomy. The approach to the dead tissue may be through a cut (incision) in the front of the abdomen, or through one of the flanks, or even via a keyhole (laparoscopic) approach. After the dead tissue has been cut away, the wound may be left open with cloth packs inside, and another operation performed in 24-48 hours to check on progress. Or tube drains may be placed inside, with irrigation fluid run though them to wash away further pus that may form. S
