Abstract:
OBJECTIVE:The purpose of this study is to assess the prognostic significance of late parenchymal pancreas necrosis as observed on serial contrast-enhanced computed tomographic (CT) scan. METHODS:Eighty-four patients with acute necrotizing pancreatitis were included. All initial CT scans were examined on complete contrast enhancement of the pancreas parenchyma (viable pancreas) or incomplete enhancement indicating parenchymal necrosis of the pancreas (PN). Secondly, all serial CT scans were evaluated to investigate whether late PN occurred in the group with a viable pancreas on initial CT scan. Characteristics of this group were evaluated. RESULTS:Thirteen patients showed signs of PN on initial CT scan. Late necrosis occurred in 5 patients. The average hospital stay in this subgroup was 46.7 days; complication rate, 100%; and mortality, 40%. A significant difference in hospital stay (average of 45.1 days vs 24.3 days; P = 0.003), complication rate (72% vs 33%; P = 0.006), and mortality (28% vs 6%; P = 0.019) was found when the group with eventual PN was compared with the group with no signs of PN (on initial and serial CT). CONCLUSIONS:This study shows a significant increase in hospital stay, complication rate, and mortality when eventual PN is shown on CT scan. Patients with late PN especially have a poor prognosis.
journal_name
Pancreasjournal_title
Pancreasauthors
Wijffels NA,van Walraven LA,Ophof PJ,Hop WC,van der Harst E,Lange JFdoi
10.1097/MPA.0b013e31802e01ecsubject
Has Abstractpub_date
2007-03-01 00:00:00pages
215-9issue
2eissn
0885-3177issn
1536-4828pii
00006676-200703000-00007journal_volume
34pub_type
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