Peripancreatic collections in acute pancreatitis: Correlation between computerized tomography and operative fi ndings  

作　　者：Santhi Swaroop Vege Joel G Fletcher Rupjyoti Talukdar Michael G Sarr 

机构地区：[1]Miles and Shirley Fiterman Center for Digestive Diseases, Rochester, MN 55905, United States [2]Department of Radiology, Mayo Clinic, Rochester, MN 55905, United States [3]Department of Surgery, Mayo Clinic, Rochester, MN 55905, United States

出　　处：《World Journal of Gastroenterology》2010年第34期4291-4296,共6页世界胃肠病学杂志（英文版）

摘　　要：AIM: To evaluate the ability of contrast-enhanced computerized tomography (CECT) to characterize the nature of peripancreatic collections.METHODS: Twenty five patients with peripancreatic collections on CECT and who underwent operative intervention for severe acute pancreatitis were retrospectively studied. The collections were classified into (1) necrosis without frank pus; (2) necrosis with pus; and (3) fluid without necrosis. A blinded radiologist assessed the preoperative CTs of each patient for necrosis and peripancreatic fluid collections. Peripancreatic collections were described in terms of volume, location, number, heterogeneity, fluid attenuation, wall perceptibility, wall enhancement, presence of extraluminal gas, and vascular compromise.RESULTS: Fifty-four collections were identif ied at operation, of which 45 (83%) were identif ied on CECT. Of these, 25/26 (96%) had necrosis without pus, 16/19 (84%) had necrosis with pus, and 4/9 (44%) had fluid without necrosis. Among the study characteristics, fluid heterogeneity was seen in a greater proportion of collections in the group with necrosis and pus, compared to the other two groups (94% vs 48% and 25%, P = 0.002 and 0.003, respectively). Among the wall characteristics, irregularity was seen in a greater proportion of collections in the groups with necrosis with and without pus, when compared to the group with fluid without necrosis (88% and 71% vs 25%, P = 0.06 and P < 0.01, respectively). The combination of heterogeneity and presence of extraluminal gas had a specif icity and positive likelihood ratio of 92% and 5.9, respectively, in detecting pus. CONCLUSION: Most of the peripancreatic collections seen on CECT in patients with severe acute pancreatitis who require operative intervention contain necrotic tissue. CECT has a somewhat limited role in differentiating the different types of collections.AIM: To evaluate the ability of contrast-enhanced computerized tomography (CECT) to characterize the nature of peripancreatic collections.METHODS: Twenty five patients with peripancreatic collections on CECT and who underwent operative intervention for severe acute pancreatitis were retrospectively studied. The collections were classified into (1) necrosis without frank pus; (2) necrosis with pus; and (3) fluid without necrosis. A blinded radiologist assessed the preoperative CTs of each patient for necrosi...

关 键 词：Contrastenhanced computerized tomogra-phy CORRELATION Pancreatic necrosis PANCREATITIS Peripancreatic fluid collection Surgery 

分 类 号：R657.51[医药卫生—外科学]