{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:56:21Z","timestamp":1787806581088,"version":"build-2784847793"},"reference-count":23,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Emphysematous pancreatitis represents the presence of gas within or around the pancreas on the ground of necrotizing pancreatitis due to superinfection with gas-forming bacteria. This entity is diagnosed on clinical grounds and on the basis of radiologic findings. Computed tomography is the preferred imaging modality used to detect this life-threating condition. The management of emphysematous pancreatitis consists of conservative measures, image-guided percutaneous catheter drainage or endoscopic therapy, and surgical intervention, which is delayed as long as possible and undertaken only in patients who continue to deteriorate despite conservative management. Due to its high mortality rate, early and prompt recognition and treatment of emphysematous pancreatitis are crucial and require individualized treatment with the involvement of a multidisciplinary team. Here, we present a case of emphysematous pancreatitis as an unusual occurrence and discuss disease features and treatment options in order to facilitate diagnostics and therapy.<\/jats:p>","DOI":"10.3390\/medicina60030406","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T11:52:55Z","timestamp":1709034775000},"page":"406","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Emphysematous Pancreatitis as a Life-Threatening Condition: A Case Report and Review of the Literature"],"prefix":"10.3390","volume":"60","author":[{"given":"Aleksandar","family":"Filipovi\u0107","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Center for Radiology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragan","family":"Ma\u0161ulovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Center for Radiology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5900-7563","authenticated-orcid":false,"given":"Du\u0161an","family":"Bulatovi\u0107","sequence":"additional","affiliation":[{"name":"Center for Radiology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milo\u0161","family":"Zako\u0161ek","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Center for Radiology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0526-1141","authenticated-orcid":false,"given":"Aleksa","family":"Igi\u0107","sequence":"additional","affiliation":[{"name":"Center for Radiology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0388-3825","authenticated-orcid":false,"given":"Tamara","family":"Filipovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"},{"name":"Institute for Rehabilitation, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/21556660.2019.1684927","article-title":"Risk factors for mortality in emphysematous pancreatitis","volume":"9","author":"Chou","year":"2020","journal-title":"J. Drug Assess."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1093\/qjmed\/hcq154","article-title":"Emphysematous pancreatitis: A severe complication of acute pancreatitis","volume":"104","author":"Porter","year":"2011","journal-title":"QJM"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e00641","DOI":"10.14309\/crj.0000000000000641","article-title":"Emphysematous Pancreatitis Mimicking fistl Perforation","volume":"8","author":"Sandhu","year":"2021","journal-title":"ACG Case Rep. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1097\/MPA.0b013e3181a9f12a","article-title":"Emphysematous pancreatitis: A less aggressive form of infected pancreatic necrosis?","volume":"38","author":"Kvinlaug","year":"2009","journal-title":"Pancreas"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1148\/radiographics.22.3.g02ma06543","article-title":"Emphysematous infections of the abdomen and pelvis: A pictorial review","volume":"22","author":"Grayson","year":"2002","journal-title":"RadioGraphics"},{"key":"ref_6","first-page":"160","article-title":"Emphysematous pancreatitis. Radiological curiosity or a cause for concern?","volume":"9","author":"Wig","year":"2008","journal-title":"JOP"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1097\/MPA.0000000000000834","article-title":"Multiorgan failure predicts mortality in emphysematous pancreatitis","volume":"46","author":"Bul","year":"2017","journal-title":"Pancreas"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"812","DOI":"10.2214\/AJR.20.23545","article-title":"Gas Where It Shouldn\u2019t Be! Imaging Spectrum of Emphysematous Infections in the Abdomen and Pelvis","volume":"216","author":"Nepal","year":"2021","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1007\/s12664-013-0322-5","article-title":"Successful outcome with conservative management of emphysematous pancreatitis","volume":"32","author":"Nadkarni","year":"2013","journal-title":"Indian J. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s00595-003-2635-y","article-title":"Primary gas gangrene of the pancreas: Report of a case","volume":"34","author":"Ikegami","year":"2004","journal-title":"Surg. Today"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1056\/ENEJMicm010312","article-title":"Images in clinical medicine. Emphysematous pancreatitis","volume":"349","author":"Bazan","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.cmi.2019.06.017","article-title":"Management of infected pancreatic necrosis in the intensive care unit: A narrative review","volume":"26","author":"Wolbrink","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.gassur.2004.05.013","article-title":"Pancreatic necrosectomy: Definitions and technique","volume":"9","author":"Traverso","year":"2005","journal-title":"J. Gastrointest. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1056\/NEJMoa0908821","article-title":"A step-up approach or open necrosectomy for necrotizing pancreatitis","volume":"362","author":"Besselink","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13017-019-0247-0","article-title":"2019 WSES guidelines for the management of severe acute pancreatitis","volume":"14","author":"Tolonen","year":"2019","journal-title":"World J. Emerg. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.4240\/wjgs.v14.i11.1179","article-title":"Diagnosis, severity stratification and management of adult acute pancreatitis-current evidence and controversies","volume":"14","author":"Chan","year":"2022","journal-title":"World J. Gastrointest. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1038\/ajg.2013.218","article-title":"American College of Gastroenterology guideline: Management of acute pancreatitis","volume":"108","author":"Tenner","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/01.mpa.0000234074.76501.a6","article-title":"Does infected pancreatic necrosis require immediate or emergency debridement?","volume":"33","author":"Connor","year":"2006","journal-title":"Pancreas"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"523","DOI":"10.47102\/annals-acadmedsg.V35N8p523","article-title":"Infected pancreatic necrosis-an evaluation of the timing and technique of necrosectomy in a Southeast Asian population","volume":"35","author":"Lee","year":"2006","journal-title":"Ann. Acad. Med. Singap."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Pinto, S., Bellizzi, S., Badas, R., Canfora, M.L., Loddo, E., Spada, S., Khalaf, K., Fugazza, A., and Bergamini, S. (2021). Direct Endoscopic Necrosectomy: Timing and Technique. Medicina, 57.","DOI":"10.3390\/medicina57121305"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Chantarojanasiri, T., Ratanachu-Ek, T., and Isayama, H. (2020). When Should We Perform Endoscopic Drainage and Necrosectomy for Walled-Off Necrosis?. J. Clin. Med., 9.","DOI":"10.3390\/jcm9124072"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/S0140-6736(17)32404-2","article-title":"Endoscopic or surgical step-up approach for infected necrotising pancreatitis: A multicentre randomised trial","volume":"391","author":"Bakker","year":"2018","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Pattarapuntakul, T., Charoenrit, T., Wong, T., Netinatsunton, N., Ovartlarnporn, B., Yaowmaneerat, T., Tubtawee, T., Boonsri, P., and Sripongpun, P. (2023). Clinical Outcomes of the Endoscopic Step-Up Approach with or without Radiology-Guided Percutaneous Drainage for Symptomatic Walled-Off Pancreatic Necrosis. Medicina, 59.","DOI":"10.20944\/preprints202301.0575.v1"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/3\/406\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:05:58Z","timestamp":1760105158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/3\/406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,27]]},"references-count":23,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["medicina60030406"],"URL":"https:\/\/doi.org\/10.3390\/medicina60030406","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,27]]}}}