Acute pancreatitis: clinical vs. CT findings.
In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptoms. This was especially true of phlegmonous pancreatitis, where the CT findings could persist for months.
D000038:Abscess / Q000175:diagnosis; D000208:Acute Disease; D000328:Adult; D002481:Cellulitis / Q000175:diagnosis; D004108:Dilatation, Pathologic / Q000175:diagnosis; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis; D006801:Humans; D008297:Male; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed