Abstract
Background
Emphysematous pancreatitis (EP) is a subtype of infected pancreatic necrosis (IPN)
characterized by presence of gas in (peri)pancreatic necrosis. However, the impacts of EP on outcomes of IPN are still controversial.
Methods
A prospective database of consecutive patients with IPN in a tertiary hospital was
post-hoc analyzed. Patients were assigned to EP and non-EP groups to perform a comprehensive
comparison.
Results
A total of 178 patients with IPN were enrolled and the overall mortality was 30.9%.
EP accounted for 20.8% (n = 37) of cases and was significantly associated with higher incidences of Escherichia coli (45.9 versus 18.4%, P = 0.001) and Klebsiella pneumoniae (56.8 versus 33.3%, P = 0.009) infection. There was scarcely any disparity in clinical characteristics
and outcomes between IPN patients with and without EP. However, patients with early-onset
EP defined as air bubble signs occurring within 2 weeks from disease onset were significantly
older and have higher prevalence of history of diabetes, and they were also associated
with significantly higher mortality (57.1 versus 8.7%, P = 0.015) compared with late-onset patients.
Conclusions
The clinical outcomes of EP might be like those of non-emphysematous infection. However,
when EP occurs within 2 weeks from disease onset, it is highly lethal.
Keywords
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Article info
Publication history
Published online: April 18, 2022
Accepted:
April 2,
2022
Received:
February 22,
2022
Identification
Copyright
© 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
