[The early recognition of infected fluid collections in acute pancreatitis in computed tomography].
Infected accumulations of abdominal fluid are a severe complication and the major cause of death (mortality rate between 20 and 60%) in patients suffering from acute pancreatitis. In 93 patients with confirmed acute pancreatitis including 28 with surgically confirmed pancreatic abscess CT findings (volume of pancreatic and extrapancreatic necrosis, capsular enhancement, gas bubble formation and contact between fluid collection and intestinum) were retrospectively correlated with clinical and operative data to assess abscess formation. This revealed a sensitivity of 0.57 in respect of pancreatic necrosis; for extrapancreatic necrosis the sensitivity was 0.39, for capsular enhancement 0.5, for gas bubble formation 0.46 and for intestinal contact 0.93. The specificity was high for gas bubbles (1.0) and intestinal contact (0.91) and low for the other criteria.


CONCLUSIONS
There is a strong relationship between fluid accumulations in direct contact with intestinal structures and the occurrence of abscess. This parameter enhances the reliability of CT in the early detection of extrapancreatic infection.
Friedrich
J M
JM
Radiologische Klinik und Poliklinik, Universität Ulm.
Leibing
U
U
Pfeifer
T
T
Schnarkowski
P
P
Büchler
M
M
Malfertheiner
P
P
Beger
H G
HG
D018784:Abdominal Abscess / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D000208:Acute Disease; D002481:Cellulitis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D005122:Exudates and Transudates / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
Zur Früherkennung infizierter Flüssigkeitsansammlungen bei akuter Pankreatitis in der Computertomographie.