[Results of computed tomographic diagnosis in the grading of acute pancreatitis]

By means of computed tomography, it is possible to classify cases of acute pancreatitis into four grades of severity with reasonable accuracy: oedematous, sero-exudative, haemorrhagic-necrotic and abscess formation. Necrotic pancreatic tissue can be differentiated from normal tissue by means of dynamic computed tomography with a high degree of accuracy and the organ can be demarcated more clearly. Of 230 patients with acute pancreatitis, 89 were treated surgically. Correlation between the CT classification and surgical findings was achieved in 83% of the cases in the three serious grades. In 86 patients (96.6%, necrosis was correctly diagnosed. The problems that arise when trying to differentiate between the haemorrhagic-necrotic form and abscess formation are discussed, particularly when there is an absence of gas in the latter type.