Imaging changes of the pancreas and the occasion of refeeding in patients with acute pancreatitis.
OBJECTIVE
To explore the objective basis of the time and characteristics of refeeding of patients with acute pancreatitis (AP).


METHODS
AP patients were randomly divided into routine group (n=105) and special group (n=99). The refeeding time and characteristics of the routine group were based on their levels of blood and urine amylase, function of the gastrointestinal tract, and symptoms and signs, and those of the special group on their imaging changes of ultrasonography and CT of the pancreas. Clinical data from the groups were analyzed prospectively and statistically.


RESULTS
At the beginning of refeeding, patients of the two groups showed a high recurrence rate of abdominal pain (routine group, 9.1%; special group, 10.5%), but no AP relapse. Three days to 2 weeks after refeeding, the patients of the routine group had a higher recurrence rate of abdominal pain (11.1%) and a relapse rate of AP(14.1%) as compared with those of the special group (P<0.05). Two weeks later, both rates decreased apparently. However, 3 days to 4 weeks after refeeding, the patients of the special group had no recurrence of abdominal pain and relapse of AP. Imaging changes of the pancreas and peripancreatic tissue were not consistent with the symptoms and signs of AP patients. The higher the Balthazar CT grading and APACHE-II score, the higher the recurrence rate of abdominal pain and the relapse rate of AP after refeeding (P<0.05).


CONCLUSIONS
Symptoms and signs were usually discordant to the imaging changes of the pancreas in AP patients. Imaging changes of the pancreas might serve as a basis for the best occasion of refeeding light semi-fluid or light food in AP patients.
Qin
Ren-Yi
RY
Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China. ryqin@tjh.tjmu.edu.cn
Qiu
Fa-Zu
FZ
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D005260:Female; D005502:Food; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000503:physiopathology*; D012008:Recurrence