Clinical, biochemical, and radiologic parameters at admission predicting formation of a pseudocyst in acute pancreatitis.
OBJECTIVE
To evaluate clinical, biochemical, and radiologic parameters at admission, which predict the development of acute pseudocyst (AP) after acute pancreatitis.


BACKGROUND
There is limited data on factors that predict the development of AP.


METHODS
Seventy-five consecutive patients with AP were prospectively enrolled and subjected to clinical, laboratory, and radiologic investigation. The patients were followed up for a period of 4 weeks and then investigated radiologically for the development of AP.


RESULTS
After exclusion, 65 patients (44 males) were studied. The median age was 37 years (40.9±15.5 y). Etiology of acute pancreatitis was alcohol in 24 patients, gallstones in 18, both in 4, drugs in 4, pancreas divisum in 2, postendoscopic retrograde cholangiopancreatography in 1, trauma in 1, and idiopathic in 11 patients. On admission, acute fluid collections were observed in 34 (52.31%) patients. Necrosis was noted in 38 (58.46%) patients (<30% necrosis, 30% to 50% necrosis, and >50% necrosis was observed in 36.8%, 26.3%, and 36.8% patients, respectively). On follow-up, 34 (52.3%) patients developed a pseudocyst. On univariate analysis, the factors significantly associated with pseudocyst formation were male sex, palpable mass, blood sugar greater than 150 mg/dL, necrosis, sepsis, acute fluid collections, presence of ascites, pleural effusion, a high grade of pancreatitis, and a high computed tomography severity index (CTSI) score. Multivariate regression analysis showed that male sex, presence of a palpable abdominal mass, ascites, and a high CTSI score were associated with the development of AP.


CONCLUSIONS
Male sex, palpable mass, ascites, and a high CTSI score at admission can predict the development of a pseudocyst after an attack of acute pancreatitis. Acute pancreatitis patients with these parameters at admission should be closely followed for the development of a pseudocyst.
Poornachandra
Kuchhangi Sureshchandra
KS
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Bhasin
Deepak Kumar
DK
Nagi
Birinder
B
Sinha
Saroj Kant
SK
Rana
Surinder Singh
SS
Shafiq
Nusrat
N
Greer
Katarina
K
Gupta
Rajesh
R
Kang
Mandeep
M
Malhotra
Samir
S
Singh
Kartar
K
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010192:Pancreatic Pseudocyst / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult