Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with persistent epigastric pain, nausea, and vomiting, status post-acute necrotizing pancreatitis. Symptoms have evolved over >4 weeks, now characterized by a palpable abdominal mass, early satiety, and low-grade fevers. No signs of acute abdomen or hemodynamic instability.
Clinical Examination Findings
Abdominal exam reveals a localized, non-tender or mildly tender epigastric mass. Bowel sounds are present. No rebound tenderness or guarding. Vitals stable, afebrile. Skin shows no signs of jaundice or ecchymosis.
Treatment Protocol
Management plan: 1. Serial imaging (CT/MRI) to monitor WON size and maturity. 2. Nutritional support (enteral preferred). 3. Analgesia as needed. 4. If symptomatic (pain, obstruction, infection), consider endoscopic ultrasound (EUS)-guided drainage or surgical necrosectomy. 5. Prophylactic antibiotics not indicated unless infection is suspected.