Kumaresan Sandrasegaran MD, Abstract Co-Author: Research grant, Siemens AG Consultant, Repligen Corporation

Mark Tann MD, Abstract Co-Author: Nothing to Disclose

Kavitha Nutakki MD, Abstract Co-Author: Nothing to Disclose

Kyle Bertrand MD, Abstract Co-Author: Nothing to Disclose

Adam Kyle Haste MD, Abstract Co-Author: Nothing to Disclose

Bilal Tahir MD, Presenter: Nothing to Disclose

Nicholas Zyromski MD, Abstract Co-Author: Nothing to Disclose

Thomas J. Howard, Abstract Co-Author: Nothing to Disclose

Recently new concepts of severe acute pancreatitis (SAP) have emerged, including disconnection of main pancreatic duct and peripancreatic fat necrosis. We wanted to determine which imaging criteria best predict medium term outcome (< 6 months) in SAP.

61 patients with SAP were retrospectively evaluated for site, presence and % volume of pancreatic and peripancreatic fat necrosis, and signs of infection. The imaging findings were correlated with the occurrence of mortality (n=2), systemic morbidity (organ failure, DIC) (n=36), local morbidity (persistent pancreatic fistula, colonic perforation) (n=25), length of hospital stay, number of surgical operations required. Multivariate generalized linear model analysis was performed.  

The mean age was 48.1 years (range 18 to 81), and there were 37 males, 24 females. Local morbidity was correlated significantly with the presence of main duct disconnection (p=0.04), peripancreatic fat necrosis (p=0.02), size of collection > 10 cm (p=0.01). Initial length of stay correlated with necrosis of > 30% of pancreas (p=0.01), and presence of duct disconnection (p=0.05). Number of operations required correlated with duct disconnection (p=0.03). CT findings did not correlate with mortality or systemic morbidity.

Substantial peripancreatic necrosis (collection > 10 cm) and main duct disconnection are associated with adverse clinical outcome.

Radiologists need to determine the severity of peripancreatic fat necrosis and presence of pancreatic duct disconnection, in addition to the volume of pancreatic necrosis, in SAP.

Sandrasegaran, K, Tann, M, Nutakki, K, Bertrand, K, Haste, A, Tahir, B, Zyromski, N, Howard, T, Imaging Findings in Severe Acute Pancreatitis: Correlation with Clinical Outcome.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11008204.html