Acute pancreatitis: inflammatory effusions--course and prognosis.

Ten to twenty per cent of Acute Pancreatitis (AP) attacks are severe and their evolution depends on regional or systemic complications and medical of surgical management applied. Three hundred and twelve cases of AP were retrospectively studied, 51 of which had pancreatic or peripancreatic effusions (early fluid effusion--14%; pseudocyst--14%; phlegmon--43% abscess--29%). Mortality in this group (33%) was greater than in the overall population (5.9%): Alcoholic etiology, concomitant systemic complications and early surgery were determinant factors. Prognostic criteria evaluated had a predictive value of about 80%. Fifty per cent of patients with phlegmon had spontaneous resolution after medical intensive care management. Diagnosis of secondary infection of pancreatic and peripancreatic necrosis is determinant for optimal surgical management. Mortality in abscess was 40%, greater when surgical drainage was done in the first two weeks of disease.