Early detection of low enhanced pancreatic parenchyma by contrast-enhanced computed tomography predicts poor prognosis of patients with acute pancreatitis.
OBJECTIVE
The usefulness of early severity assessment of acute pancreatitis (AP) by contrast-enhanced computed tomography (CECT) was investigated.


METHODS
Data were obtained from a 2007 nationwide survey in Japan. Clinical data of 983 patients with AP were analyzed. All were examined by CECT on the day of admission.


RESULTS
Early findings of CECT demonstrated that low enhanced pancreatic parenchyma (LEPP) was associated with the incidence of organ failure (OF), multiple OF, and infectious complications as well as mortality (P < 0.0001). Next, patients were further divided into 4 groups according to the CECT findings, which focused on the LEPP and peripancreatic collections (PPCs). The LEPP/PPC (+/+) group was characterized as high morbidity and high mortality. The incidence of OF (28.2%), multiple OF (15.5%), and mortality (11.4%) in patients assigned to the (+/+) group was significantly higher than in those assigned to the other groups. The incidence of infectious complications was significantly higher in patients assigned to the (+/+) group (16.7%), the (+/-) group (9.0%), and the (-/+) group (7.0%) than those assigned to the (-/-) group (1.8%).


CONCLUSIONS
The detection of LEPP and PPC was a useful CECT finding for the early assessment of the severity of AP.
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai City, Miyagi, Japan.
Morihisa
M
Hirota
Kennichi
K
Satoh
Kazuhiro
K
Kikuta
Atsushi
A
Masamune
Kiyoshi
K
Kume
Shin
S
Hamada
Akihiko
A
Satoh
Atsushi
A
Kanno
Jun
J
Unno
Hiromichi
H
Ito
Hiroyuki
H
Ariga
Tooru
T
Shimosegawa
D000208:Acute Disease; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000000981:diagnostic imaging*; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media