Introduction : Acute pancreatitis evolves in pancreatic abscess (PA) about 2% of patients and, if intervention and drainage are not undertaken, the mortality rate is 100%. PA is usually due to evolution of acute necrotizing pancreatitis and superinfection pseudocyst.

Methods : From 2008 to 2017, 3 cases of pancreatic abscess have been treated in our Academic Department of General Surgery.

Results : Case 1: a 27-year-old man was submitted to surgery for multiple penetrating gunshot trauma, requiring two consecutive surgical operations. In the postoperative period the patient developed PA. A percutaneous CT-guided drainage of the homogeneous fluid collection was successfully performed and the patient was discharged 80 days from the first operation. Case 2: a 60-year-old man was admitted with fever, abdominal pain and general malaise after acute pancreatitis treatment and cholecystectomy. CT scan revealed an heterogeneous 21x18 cm low-density lesion in the pancreatic head due to PA. A surgical debridement was performed and the patient was discharged from hospital 15 days after surgery. Case 3: a 65-year-old man developed a PA due to acute pancreatitis for gallstones disease. Ct scan revealed a heterogeneous 8x6 cm pancreatic lesion managed by surgical debridement. The postoperative course was uneventful, and the patient was discharged 17 days after surgery.

Conclusions : The growing consent for minimal invasive approach, as fine needle aspiration or drainage catheter placement performed by endoscopic ultrasound, seems to open new prospective for the treatment of pancreatic abscess. Nevertheless, surgical debridement and percutaneous CT-guided drainage are still considered the gold standard treatments.