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Updated: Feb 12, 2026
Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis
Published on: January 27, 2023
MR imaging of hemorrhage associated with acute pancreatitis
Meng Yue Tang1, Tian Wu Chen1, Thomas L Bollen2
1Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 63, Nanchong 637000, Sichuan, PR China.
Purpose:
To study MRI findings of hemorrhage in acute pancreatitis (AP) and correlate the presence and extent of hemorrhage with the MR severity index (MRSI), Acute Physiology And Chronic Health Evaluation (APACHE) II scores, and clinical outcome.
Materials And Methods:
This retrospective study included 539 patients with AP. Hemorrhage was defined as areas of hyperintensity in or outside the pancreas on liver imaging with volume acceleration flexible (LAVA-Flex). The presence of hemorrhage was classified into three areas: within the pancreatic parenchyma, retroperitoneal space, and sub-or intraperitoneal space. Involvement of each area was awarded 1 point resulting in the hemorrhage severity index (HSI) score. The predicted severity of AP was graded by MRSI and APACHE II score. The association between HSI, MRSI, and APACHE II scores was analyzed. The length of hospital stay and organ dysfunction was used as clinical outcome parameters.
Results:
Among 539 AP patients, 62 (11.5%) had hemorrhage. The prevalence of hemorrhage was 1.1% (2/186), 13.9% (43/310), and 39.5% (17/43) in predicted mild, moderate, and severe AP, respectively, based on MRSI (χ2 = 55.3, p = 0.00); and 7.7% (21/273) and 19.2% (18/94) in predicted mild and severe AP, respectively, based on APACHE II (χ2 = 21.2, p = 0.00). HSI score significantly correlated with MRSI (r = 0.36, p < 0.001) and APACHE II scores (r = 0.21, p = 0.00). The prevalence of organ dysfunction was higher and length of hospital stay was longer in patients with hemorrhage than in those without hemorrhage (p < 0.01).
Conclusions:
Hemorrhage in AP is common. The presence of hemorrhage, rather than its extent, correlates with poor clinical outcome.
Insights
Hemorrhage in acute pancreatitis (AP) is common, affecting 11.5% of patients. Its presence, not extent, correlates with worse clinical outcomes like organ dysfunction and longer hospital stays.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Acute pancreatitis (AP) is a serious condition with varied severity.
- Hemorrhage is a known complication of AP, but its diagnostic and prognostic significance requires further elucidation.
- Magnetic Resonance Imaging (MRI) offers detailed visualization of pancreatic and peripancreatic tissues.
Purpose of the Study:
- To investigate MRI findings of hemorrhage in acute pancreatitis.
- To correlate the presence and extent of hemorrhage with established severity scores (MRSI, APACHE II) and clinical outcomes.
Main Methods:
- Retrospective analysis of 539 AP patients using MRI (LAVA-Flex sequence).
- Hemorrhage identified as hyperintensities; severity quantified by Hemorrhage Severity Index (HSI).
- Correlation of HSI, MRSI, and APACHE II scores with clinical outcomes (hospital stay, organ dysfunction).
Main Results:
- Hemorrhage detected in 11.5% of AP patients.
- Hemorrhage prevalence increased significantly with higher MRSI and APACHE II scores (p<0.001).
- HSI showed significant correlation with MRSI (r=0.36) and APACHE II (r=0.21) scores (p<0.001).
Conclusions:
- Hemorrhage is a frequent finding in acute pancreatitis.
- The presence of hemorrhage, irrespective of its extent, is associated with poorer clinical outcomes, including increased organ dysfunction and prolonged hospitalization.
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