MANAGEMENT OF COMPLICATED ACUTE-PANCREATITIS - IMPACT OF COMPUTED-TOMOGRAPHY

被引:4
作者
FAN, ST
CHOI, TK
CHAN, FL
LAI, ECS
WONG, J
机构
[1] UNIV HONG KONG,DEPT SURG,HONG KONG,HONG KONG
[2] QUEEN MARY HOSP,DEPT RADIOL,HONG KONG,HONG KONG
关键词
acute pancreatitis; computed tomography;
D O I
10.1111/j.1440-1746.1990.tb01812.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Abstract The usefulness of computed tomography (CT) in guiding the management of 43 patients who had a complicated clinical course of acute pancreatitis was retrospectively studied. The CT scans were performed when patients had persistent fever, leucocytosis, hyperamylasaemia, palpable abdominal masses or when there was organ failure. The CT scans showed normal findings in six patients, features of pancreatic abscess in three patients, pseudocysts in three patients and inflammatory masses (a mixture of sterile inflammation and necrosis) in 31 patients. Patients with pancreatic abscesses underwent emergency laparotomy, drainage and debridement; patients with pseudocysts had delayed drainage unless complication occurred; patients with normal CT scan or findings of inflammatory masses were managed conservatively. For patients undergoing conservative management, repeated CT scanning and percutaneous aspiration of the inflammatory mass was performed when pancreatic sepsis was strongly suspected. By this approach, basing on careful clinical and CT scan surveillance, five patients with pancreatic sepsis (pancreatic abscess and localized abscess collection in pseudocyst) underwent emergency surgery and four survived, while 25 patients with inflammatory masses were successfully managed conservatively and some who may have been operated on clinical grounds were spared unnecessary early debridement surgery. Copyright © 1990, Wiley Blackwell. All rights reserved
引用
收藏
页码:103 / 109
页数:7
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