Pancreatic necrosis: CT manifestations
Radiology
|February 1, 1986
Summary
Computed tomography (CT) effectively diagnoses pancreatic necrosis, a severe complication of acute pancreatitis. CT imaging reveals characteristic changes in subacute and chronic stages, aiding therapeutic planning and management of superinfections.
Area of Science:
- Radiology
- Gastroenterology
- Surgical Pathology
Background:
- Pancreatic necrosis, a severe complication of acute pancreatitis, involves devitalized tissue.
- Accurate diagnosis is crucial for therapeutic planning but challenging with clinical and laboratory data alone.
Purpose of the Study:
- To evaluate the utility of computed tomography (CT) in diagnosing pancreatic necrosis.
- To correlate CT findings with the developmental stage of pancreatic necrosis.
Main Methods:
- Retrospective analysis of CT examinations in 22 patients with pancreatic necrosis over 18 months.
- Correlation of CT findings with clinical and pathological data.
- CT-guided aspiration for culture in suspected superinfections.
Main Results:
- CT findings varied with the stage of necrosis; overlap with phlegmon occurred in the acute phase.
- Subacute and chronic stages showed diffuse gland enlargement, decreased central density, and a saclike configuration.
- Negative cultures in two patients allowed for more elective surgical intervention.
Conclusions:
- CT is valuable for diagnosing pancreatic necrosis and assessing its stage.
- Characteristic CT findings aid in differentiating necrosis from phlegmon and planning treatment.
- CT-guided aspiration can inform management decisions regarding superinfection.
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