Document Detail

Prediction of pancreatic necrosis by dynamic pancreatography.
MedLine Citation:
PMID:  2802834     Owner:  NLM     Status:  MEDLINE    
Parenchymal necrosis has recently been recognized as the principal determinant of the incidence of secondary infection in acute pancreatitis. Because secondary infection of pancreatic necrosis accounts for more than 80% of all deaths from acute pancreatitis, a method for determining the presence or absence of parenchymal necrosis would offer considerable prognostic and therapeutic information. Thirty seven patients with unequivocal acute pancreatitis and five normal controls were prospectively studied with intravenous bolus, contrast-enhanced computed tomography (dynamic pancreatography). In the absence of pancreatic necrosis, there were no significant differences in parenchymal enhancement between any of the following patient groups: controls (5), uncomplicated pancreatitis (20), pancreatic abscess (7), or peripancreatic necrosis (4)(p less than 0.05). On the other hand, pancreatic parenchymal enhancement was significantly reduced or absent in all six patients with segmental or diffuse pancreatic necrosis (p less than 0.05). Postcontrast pancreatic parenchymal enhancement was also found to be inversely correlated with the number of Ranson signs (p less than 0.001). Dynamic pancreatography offers prognostic information and is a safe and reliable technique for predicting the presence or absence of pancreatic parenchymal necrosis.
E L Bradley; F Murphy; C Ferguson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of surgery     Volume:  210     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  1989 Oct 
Date Detail:
Created Date:  1989-10-28     Completed Date:  1989-10-28     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  495-503; discussion 503-4     Citation Subset:  AIM; IM    
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
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MeSH Terms
Abscess / radiography
Acute Disease
Analysis of Variance
Contrast Media / administration & dosage*
Middle Aged
Necrosis / radiography
Pancreatitis / complications,  mortality,  radiography*
Prospective Studies
Tomography, X-Ray Computed*
Reg. No./Substance:
0/Contrast Media

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