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Clinical, biochemical, and radiologic parameters at admission predicting formation of a pseudocyst in acute pancreatitis.
MedLine Citation:
PMID:  20628310     Owner:  NLM     Status:  In-Data-Review    
GOALS: To evaluate clinical, biochemical, and radiologic parameters at admission, which predict the development of acute pseudocyst (AP) after acute pancreatitis.
BACKGROUND: There is limited data on factors that predict the development of AP.
STUDY: Seventy-five consecutive patients with AP were prospectively enrolled and subjected to clinical, laboratory, and radiologic investigation. The patients were followed up for a period of 4 weeks and then investigated radiologically for the development of AP.
RESULTS: After exclusion, 65 patients (44 males) were studied. The median age was 37 years (40.9±15.5 y). Etiology of acute pancreatitis was alcohol in 24 patients, gallstones in 18, both in 4, drugs in 4, pancreas divisum in 2, postendoscopic retrograde cholangiopancreatography in 1, trauma in 1, and idiopathic in 11 patients. On admission, acute fluid collections were observed in 34 (52.31%) patients. Necrosis was noted in 38 (58.46%) patients (<30% necrosis, 30% to 50% necrosis, and >50% necrosis was observed in 36.8%, 26.3%, and 36.8% patients, respectively). On follow-up, 34 (52.3%) patients developed a pseudocyst. On univariate analysis, the factors significantly associated with pseudocyst formation were male sex, palpable mass, blood sugar greater than 150 mg/dL, necrosis, sepsis, acute fluid collections, presence of ascites, pleural effusion, a high grade of pancreatitis, and a high computed tomography severity index (CTSI) score. Multivariate regression analysis showed that male sex, presence of a palpable abdominal mass, ascites, and a high CTSI score were associated with the development of AP.
CONCLUSIONS: Male sex, palpable mass, ascites, and a high CTSI score at admission can predict the development of a pseudocyst after an attack of acute pancreatitis. Acute pancreatitis patients with these parameters at admission should be closely followed for the development of a pseudocyst.
Kuchhangi Sureshchandra Poornachandra; Deepak Kumar Bhasin; Birinder Nagi; Saroj Kant Sinha; Surinder Singh Rana; Nusrat Shafiq; Katarina Greer; Rajesh Gupta; Mandeep Kang; Samir Malhotra; Kartar Singh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  45     ISSN:  1539-2031     ISO Abbreviation:  J. Clin. Gastroenterol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  159-63     Citation Subset:  IM    
Departments of *Gastroenterology †Clinical Pharmacology §Surgery ∥Radiodiagnosis, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India ‡Division of Gastroenterology, University Hospitals Case Medical Center, Cleveland, OH.
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