Document Detail


Pancreatic pseudocysts: Prognostic factors for their development and their spontaneous resolution in the setting of acute pancreatitis.
MedLine Citation:
PMID:  22487516     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND AND AIM: Previous studies on the development of pancreatic pseudocysts following acute pancreatitis were monocentric, mostly retrospective, did not fulfil the Atlanta criteria, and featured a mixture of patients with post-acute and chronic pancreatitis. Therefore, the natural course of pancreatic pseudocysts after acute pancreatitis and the reasons for their spontaneous resolution remain unknown.
METHODS: This prospective study of 369 patients investigated the prognostic factors for development of pancreatic pseudocysts and for their spontaneous resolution after a first episode of acute pancreatitis.
RESULTS: On discharge, 124 (34%) patients still had pancreatic fluid collections. The prognostic factor for these fluid collections was severe acute pancreatitis. Follow-up examination 3 and 6 months later showed pancreatic pseudocysts in 36 (10%) patients (30 with and 6 without prior fluid collection), and in 27 (7%) patients (25 with and 2 without pancreatic pseudocyst after 3 months), respectively. The prognostic factors for their development were alcohol abuse and an initial severe course of the disease. Spontaneous complete resolution of the pancreatic pseudocysts occurred in 11 (31%) of the 36 patients. Prognostic factors for the spontaneous resolution were no or mild symptoms (nausea, vomiting, abdominal pain) and a maximal cyst diameter of <4 cm.
CONCLUSIONS: Patients with a first severe attack of acute pancreatitis and fluid collections at discharge should be checked by ultrasonography for pancreatic pseudocysts 3 months later. In patients with a small pseudocyst and mild symptoms therapy may be postponed for a further 3 months, since spontaneous resolution is possible.
Authors:
Paul Georg Lankisch; Bettina Weber-Dany; Patrick Maisonneuve; Albert B Lowenfels
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Publication Detail:
Type:  Journal Article     Date:  2012-02-16
Journal Detail:
Title:  Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]     Volume:  12     ISSN:  1424-3911     ISO Abbreviation:  Pancreatology     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-04-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100966936     Medline TA:  Pancreatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  85-90     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 IAP and EPC. Published by Elsevier B.V. All rights reserved.
Affiliation:
Clinic of General Internal Medicine, Municipal Clinic of Lüneburg, Lüneburg, Germany.
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