CT of acute pancreatitis: interim assessment

a retrospective review of 102 ptients with the clinical diagnosis of acute pancreatitis undergoing computed tomographic (CT) evaluation during a 9 month period revealed 32 patients with abnormal CT scans. All 32 had enlargement of the pancreas. The extent of inflammatory process on these patients was examined. Twenty patients exhibited a phlegmonous mass extending into the region of the lesser sac. There was involvement of the left anterior pararenal space in 13 (the right in three and both in four). Eight patients demonstrated involvement of the posterior pararenal space, and in seven of these the inflammatory process extended down the psoas muscle into the pelvis. Five patients had involvement of the transverse mesocolon and small bowel mesentery. Eight patients developed a pseudocyst during the acute phase of the disease, 11 developed a pancreatic abscess, and two showed evidence of pancretic hemorrhage. This experience prompted a prospective study of the clinical course of acute pancreatitis relative to the extent of disease as recognized by CT.