Serial computed tomography is rarely necessary in patients with acute pancreatitis : A prospective study in 102 patients

Abstract Background: CT has proved to be helpful in patients with acute pancreatitis for differentiating between mild and severe forms. Followup of acute pancreatitis with CT has been advocated but rarely studied. The aim of this study was to determine if late CT performed at day 7 might be helpful in establishing the prognosis or the type of complications, and to select a subgroup of patients in whom CT could be beneficial. Study Design: Contrast-enhanced CT was performed at the admission day and 7 days after admission in 102 patients admitted for acute pancreatitis. The extent of pancreatic inflammation was classified according to Balthazar grade, and intrapancreatic necrosis on these examinations was prospectively assessed and compared with clinical and biologic data and with patient outcomes. Results: Among 102 patients, complications developed in 24 (23%). Complications developed in only 8% of patients with Ranson score 50%. Late CT was predictive of complications in cases of intrapancreatic necrosis enlarging since the first examination. Conclusions: Our study showed that in acute pancreatitis: 1) there is little justification for systematic early CT, especially in patients with Ranson score