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[Salmonella pancreatic abscess. Treatment by drainage without cholecystectomy]

H Johanet1, J P Marmuse, M Toublanc

  • 1Service de Chirurgie Générale et Digestive, Hôpital Bichat, Paris.

Insights

A pancreatic necrotic collection infected by Salmonella typhimurium was successfully treated with necrosectomy and antibiotics. This approach, without gallbladder removal, led to an uneventful recovery and complete bacterial eradication.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Pancreatic necrotic collections can become infected, posing significant treatment challenges.
  • Salmonella typhimurium is a potential pathogen in pancreatic infections.
  • Cholecystectomy is often considered in patients with pancreatic infections, but its necessity is debated.

Observation:

  • A case of pancreatic head necrosis infected with Salmonella typhimurium is presented.
  • The patient underwent necrosectomy and received antibiotic therapy.
  • Cholecystectomy was not performed during the treatment course.

Findings:

  • The patient's pancreatic disease course was uneventful following the intervention.
  • Complete sterilization of the infected necrotic collection was achieved.
  • Quinolone antibiotic therapy was instrumental in eradicating the Salmonella typhimurium infection.

Implications:

  • Necrosectomy combined with targeted antibiotic therapy can be effective for infected pancreatic necrosis.
  • Conservative management, omitting cholecystectomy, may be a viable option in select cases.
  • Quinolone antibiotics demonstrate efficacy in sterilizing Salmonella typhimurium-infected pancreatic collections.

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