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Completion Pancreatectomy for Treatment of a Clostridium perfringens Pancreatic Infection

Jovenel Cherenfant, MD; Mehrdad Nikfarjam, MD, PhD; Abraham Mathew, MD; Eric T. Kimchi, MD; Kevin F. Staveley-O’Carroll, MD, PhD
Arch Surg. 2009;144(4):368-370. doi:10.1001/archsurg.2009.17.
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Pancreatic infection is associated with high morbidity and mortality. Drainage of the infection is the usual therapeutic approach. Clostridium perfringensinfection can cause fulminant sepsis, but it rarely occurs within the pancreas. The case of a 76-year-old man with cystic pancreatic lesions in which sepsis developed after endoscopic ultrasound with fine-needle aspiration biopsy is described. The sepsis was managed with pancreatic resection and antibiotics. Clostridium perfringenswas isolated from blood cultures and microbiologic smears from the pancreas. Invasive intraductal papillary mucinous neoplasm with lymph node involvement was identified on histologic examination. The patient made a complete recovery from surgery without complications.

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A, Computed tomography scan showing cystic lesions within the pancreas before endoscopic ultrasound–fine-needle aspiration (EUS-FNA). B, Computed tomographic scan performed 4 hours after EUS-FNA showing gas within cystic pancreatic lesion (arrow) extending into surrounding tissue.

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