title: Intense adrenal enhancement in patients with acute pancreatitis and early organ failure.
abstract: Intense adrenal enhancement has previously been reported in patients with hypovolemic and septic shock. The purpose of this study was to assess whether this computed tomography (CT) finding is also observed in patients presenting with severe acute pancreatitis and early organ failure. A retrospective analysis of a prospectively collected database was performed. Out of 38 consecutive patients with predicted severe acute pancreatitis, 3 patients showed intense bilateral adrenal enhancement on early CT. All patients had early multiple organ failure and subsequently died. In two cases, pathologic correlation was obtained. Intense adrenal enhancement may be a new prognostic indicator in patients with acute pancreatitis, particularly when organ failure is present at the time of CT examination. Further studies are necessary to confirm this observation.
authors.affiliation: Department of Radiology, St. Antonius Hospital, Koekoekslaan 1, P.O. Box 2500, 3430 EM, Nieuwegein, The Netherlands. tlbollen@gmail.com
authors.forename: T L
authors.initials: TL
authors.lastname: Bollen
authors.forename: H C
authors.initials: HC
authors.lastname: van Santvoort
authors.forename: M G H
authors.initials: MG
authors.lastname: Besselink
authors.forename: B
authors.initials: B
authors.lastname: van Ramshorst
authors.forename: H W
authors.initials: HW
authors.lastname: van Es
authors.forename: H G
authors.initials: HG
authors.lastname: Gooszen
mesh_terms: D000208:Acute Disease; D000311:Adrenal Glands / Q000000981:diagnostic imaging*; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D009102:Multiple Organ Failure / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol