Emphysematous pancreatitis: a rare entity with characteristic radiological findings COMMENT

Emphysematous pancreatitis, which consists of the necrotic infection of the pancreatic gland, is a rare entity with significant morbidity and mortality. It presents some characteristic radiological findings, visualizing gas at the level of the pancreatic parenchyma associated with the presence of gas-forming bacteria. For differential diagnosis, the presence of entero-pancreatic fistulas (1), as well as the presence of gas secondary to endoscopic instrumentation, sphincterotomy, or previous trauma, must be excluded. The extraction of culture allows confirming the infection of the necrotic tissue. Gram-negative bacilli are the most frequently involved bacteria (2). This entity usually requires broad-spectrum antibiotic treatment, intensive care, and debridement of infected necrotic tissue. Although percutaneous debridement may choose initially, surgical resection is still necessary in refractory cases (3).