7. Disseminated intravascular coagulopathy
8. Protein energy malnutrition
Local fluid collection
• Small collection – reactionary.
• Massive ascites and pleural effusion due to
internal panceatic fistula.
• Treatment :
1. ERCP to detect site of leakage followed by
2. Distal pancreatic resection or internal drainage
in Roux en Y jejunostomy.
• Peripancreatic fluid collection contained by
fibrous granulation tissue contrast to cystic
neoplasm having epithelialized wall.
• D’ Egidio classification:
Type I Acute post necrotic cyst
Type II Post necrotic cyst
Type III Retention cyst
Complications of pseudocyst
3. Mass effect
• Type I percutaneous drainage
• Type II and III internal drainage
• May be sterile or infected.
• Treated by debridement (necrosectomy).
• Arise from infection of pancreatic collection.
• Ideally should not contain necrotic debris.
• Must be differentiated from infected
Clinical features of pancreatic abscess
3. Abdominal pain
1. Percutaneous drainage radiolgically
2. Endoscopic drainage with placement of
double j stent
• SIRS : Tachypnea, tachychardia, leucocytosis
• Sepsis could be there.
• May progress to MODS
• Treatment is supportive care.