Necrotizing pancreatitis Q - matata917

[ArchivalUser]

A 66-year old man is admitted with acute pancreatitis with a Ranson score of 7. During the first 10 days of hospitalization he has high spike fevers and marked leukocytosis. Blood cultures are negative. He has been receving total parenteral nutrition and imipenem since admission. Urine cultures are growing fungus today. CT shows acute pancreatic necrosis at approximately 40%. What is the next best step?

a. stop imipenem, begin meropenem, and observe over the next 48 hours
b. surgical debriment
c. CT-guided fine-needle aspiration of the pancreatic bed
d. ERCP

[ArchivalUser]

C- ct gided aspiration.

[ArchivalUser]

C.

[ArchivalUser]

ddddddddd

[ArchivalUser]

CC

[ArchivalUser]

C. Ct guided
pancreatic abscess should be drained. Meropenem is not superior to imipenem

[ArchivalUser]

b...40% necrosis..

[ArchivalUser]

BBBBBBBBBBBBB

[ArchivalUser]

should be B

[ArchivalUser]

Well, the answer is CCCCCCCCCCCCCCCCC

This patient has pancreatic necrosis and needs immediate surgical evalvation for CT Guided Percutaneous Aspiration and Culture.

If the Culture shows infection then the next step is " Surgical Debridement"

So, here the next step is "CT Guided Aspiration and Culture.