Natural History of Gas Configurations and Encapsulation in Necrotic Collections During Necrotizing Pancreatitis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-09

AUTHORS

Janneke van Grinsven, Sandra van Brunschot, Mark C. van Baal, Marc G. Besselink, Paul Fockens, Harry van Goor, Hjalmar C. van Santvoort, Thomas L. Bollen, The Dutch Pancreatitis Study Group

ABSTRACT

BACKGROUND: Decision-making on invasive intervention in patients with clinical signs of infected necrotizing pancreatitis is often related to the presence of gas configurations and the degree of encapsulation in necrotic collections on imaging. Data on the natural history of gas configurations and encapsulation in necrotizing pancreatitis are, however, lacking. METHODS: A post hoc analysis was performed of a previously described prospective cohort in 21 Dutch hospitals (2004-2008). All computed tomography scans (CTs) performed during hospitalization for necrotizing pancreatitis were categorized per week (1 to 8, and thereafter) and re-assessed by an abdominal radiologist. RESULTS: A total of 639 patients with necrotizing pancreatitis were included, with median four (IQR 2-7) CTs per patient. The incidence of first onset of gas configurations varied per week without a linear correlation: 2-3-13-11-10-19-12-21-12%, respectively. Overall, gas configurations were found in 113/639 (18%) patients and in 113/202 (56%) patients with infected necrosis. The incidence of walled-off necrosis increased per week: 0-3-12-39-62-76-93-97-100% for weeks 1-8 and thereafter respectively. Clinically relevant walled-off necrosis (largely or fully encapsulated necrotic collections) was seen in 162/379 (43%) patients within the first 3 weeks. CONCLUSIONS: Gas configurations occur in every phase of the disease and develop in half of the patients with infected necrotizing pancreatitis. Opposed to traditional views, clinically relevant walled-off necrosis occurs frequently within the first 3 weeks. More... »

PAGES

1557-1564

References to SciGraph publications

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URI

http://scigraph.springernature.com/pub.10.1007/s11605-018-3792-z

DOI

http://dx.doi.org/10.1007/s11605-018-3792-z

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https://app.dimensions.ai/details/publication/pub.1103954660

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29752684


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