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Contrast-enhanced CT scan showing spread of inflammation throughout the abdomen. (a) Axial view, (b) Coronal view.
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Abdominal CT revealed the spread of inflammation throughout the abdomen (Fig. 1).
Abdominal CT scan obtained on (a)day16, (b)day23, and (c)day42 of hospitalization showing gradual transformation of ascites into an abdominal abscess (arrow).
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We performed necrosectomy on day43 of hospitalization because ascitic fluid infection led to abscess formation (Fig. 2).
(a)Intraoperative findings showing removal of the abscess located anterior to the site of the pancreaticojejunostomy (arrow) and right paracolic gutter. (b)Image showing the removed necrotic tissue.
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We carefully removed as much necrotic tissue as was possible, without injury to the pancreaticojejunal anastomosis and ascending colon (Fig. 3).