Predictive
Factors for Pseudocysts and Peripancreatic Collections in Acute
Pancreatitis
download
Full Article (PDF file)
Mircea Diculescu1,
Mirela Ciocîrlan2, Mihai Ciocîrlan1, Dan Stanescu3,
Tudor Ciprut2, Teohari Marinescu1
1) Gastroenterology
and Hepatology Center, Fundeni Clinical Institute. 2) Department
of Gastroenterology, “Elias” Emergency Universitary
Hospital. 3) Department of Nuclear Medicine and Ultrasound,
Fundeni Clinical Institute, Bucharest, Romania
Abstract
Background.
Acute pancreatitis (AP) is a proteiform disease which may lead
to various complications. Pancreatic pseudocysts and fluid collections
are among the most frequent of them. The aim of our study was
to find predictive factors of their occurrence.
Methods.
We carried out a retrospective cohort study comprising one year
patients admitted to our department with AP. Fisher’s
exact and U Mann Whitney tests were used for correlations, with
a probability of error < 5% (p<0.05).
Results.
We included 62 patients with a mean age of 49 years; 77.4% were
males. AP etiology was due to alcohol (58.1%), biliary disorders
(22.6%), hyper-triglycerides (8.1%) and post-ERCP (3.2%). Pancreatic
cancer was revealed in (6.5%) patients. From the whole group
2 patients (3.2%) died. There were 22 patients with pseudocysts
(35.5%) and 13 patients with acute fluid collections (21%).
Multiple pseudocysts were present in 12 cases (54.5%), mean
diameter was 39.5 mm. Pancreatic head localization was most
frequent (63.6%). Alcoholic etiology was associated with acute
pseudocysts formation (p=0.007) as well as lower values of alkaline
phosphatase (96 U/L versus 286 U/L, p = 0.016). The area under
the receiver operating characteristics curve demonstrated values
of alkaline phosphatase < 2 x upper normal values were predicting
pseudocyst occurrence with > 90% specificity. Presence of
ascites predicted formation of acute fluid collections, (p <
10-3).
Conclusions.
Alcoholic etiology and low values of serum alkaline phosphatase
seem to predict pseudocysts formation in acute pancreatitis,
while ascites forecast acute fluid collections occurrence.
Key words
Acute pancreatitis
- pseudocysts - fluid collections
