Computed tomography of pararenal fluid collections in acute pancreatitis

Acute pancreatitis is a serious condition with severe and, sometimes, fatal complications. In recent years, both computed tomography (CT) and ultrasound have improved the diagnosis of certain complications, particularly pseudocysts, extrapancreatic exudates and abscesses. A frequent site for extrapancreatic exudates is the pararenal space. Reports in the CT literature have suggested that pararenal exudates are rare on the right but common on the left in acute pancreatitis. A series is presented here of nine patients with acute pancreatitis, seven of whom had right pararenal exudates demonstrated on CT examination. Patients with diffuse pancreatitis had bilateral pararenal exudates whilst those with inflammation confined either to the head and neck or to the tail of the pancreas had appropriate unilateral exudates. The detection and drainage of extrapancreatic exudates in acute pancreatitis may significantly influence morbidity.