30 Jan 2017

Transperitoneal Necrosectomy

45 year old female with history of idiopathic acute necrotising pancreatitits
Spent more than one month for severe attack with multi organ failure
Had tracheostomy and two pigtail insertion for infective collection
Recovered well from organ dysfunction
She had persistent fever and pus discharge from both drains
CT scan done after two and half months of attack
Findings suggestive of multiple necrotic collection & splenic abscess
Spleenic flexure encased in tail pancreas fibrosis leading to obstruction
Open Transperitoneal necrosectomy was done with diverting ileostomy.
Postoperative stay in ICU for 1 day and full diet started.
She had residual 20 ml collection in spleenic fossa
Pigtail insertion done for same and she recovered well.

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