Splenic parenchymal complications of pancreatitis: CT findings and natural history.
OBJECTIVE
Splenic parenchymal complications of pancreatitis are unusual and potentially life threatening. They usually require splenectomy in patients in poor condition. The present study describes natural history of splenic parenchymal complications and the role of CT scan in diagnosis and follow-up.


METHODS
A retrospective study of 16 consecutive patients with splenic complications diagnosed by CT during staging of pancreatitis was performed. The presence and importance of splenic infarct, abscess, subcapsular collection, and hemoperitoneum were correlated with the patients' symptoms, type of management, and follow-up.


RESULTS
No specific symptomatology was observed except in two cases of acute and massive hemoperitoneum. Fourteen infarcts, 11 subcapsular collections, 1 abscess, and 3 hemoperitoneums were observed. Four patients underwent splenectomy including two as an emergency for hemodynamic instability. Twelve patients were conservatively and successfully managed.


CONCLUSIONS
Most splenic parenchymal complications of pancreatitis regress spontaneously and may be managed conservatively. Surgical indication is based mainly on clinical findings. CT is useful for detection and follow-up of these complications.
Rypens
F
F
Department of Radiology, Erasme Hospital, Brussels, Belgium.
Devière
J
J
Zalcman
M
M
Braudé
P
P
Van de Stadt
J
J
Struyven
J
J
Van Gansbeke
D
D
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D000328:Adult; D000368:Aged; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006465:Hemoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging; D013158:Splenic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D013159:Splenic Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed