[Leukocyte scintigraphy in the diagnosis of acute pancreatitis]

The authors investigate the place and clinical usability of the 99mTc-HM-PAO leukocyte scintigraphy (LS) in patients with acute pancreatitis. Another purpose was to establish the diagnostic value of LS to differenciate between infected and noninfected pseudocysts following acute pancreatitis. Seventy-five patients with acute pancreatitis were examined and divided into two groups. In group 1, LS was performed in 46 consecutive patients in the early phase (mean 3 days following the beginning of the symptoms, range 1-6 days) of acute pancreatitis. In group 2, LS was performed in 29 patients with pancreatic pseudocysts following acute pancreatitis. The diagnosis of acute pancreatitis was based on the typical clinical symptoms, laboratory parameters, Ranson criteria, US and CT findings. In group 1, most of the cases with a severe clinical outcome (Ranson classification) gave positive LS results (13/15). Leukocyte accumulation was also detected in patients with mild acute pancreatitis (5/26), but at a lower frequency. The scintigraphic activity correlated with the leukocyte count, fever, and duration of hospitalization. In group 2, there were seven LS positive cases. A pancreatic abscess or infected pseudocyst was found in all of them during surgery. In 9 LS negative cases surgery and bacterial culturing revealed sterile pseudocyst. In conclusion, a positive LS indicated a severe course of acute pancreatitis. The method also seems useful for differentiation between infected and noninfected pancreatic pseudocysts.