Pancreatic abscess: Impact of computerized tomography on early diagnosis and surgery

Richard A. Crass, Anthony A. Meyer, R. Brooke Jeffrey, Michael P. Federie, James H. Grendell, Vivian W. Wing, Donald D. Trunkey

    Research output: Contribution to journalArticle

    33 Scopus citations

    Abstract

    Pancreatic abscess continues to be a lethal complication of acute pancreatitis, with mortality rates of 40 percent in recent surgical series. A major factor contributing to this high mortality has been delay in diagnosis. When combined with diagnostic needle aspiration, computerized tomographic scanning has greatly enhanced the early detection of pancreatic abscesses. In a 4 year period at our institutions, 21 patients with proved pancreatic abscesses were evaluated early in their clinical course by computerized tomography. On follow-up ranging from 7 months to 3 1 2, years, there were only four deaths for a mortality rate of 19 percent. Many of the surviving patients had a long and protracted clinical course (mean length of hospitalization was 56 days) and reoperation for recurrent abscess or gastrointestinal complications was required in eight patients (38 percent). Computerized tomography proved to be of considerable value in localizing the site of de novo or recurrent pancreatic abscess and in detecting postoperative complications. An aggressive approach encompassing early computerized tomographic scanning with diagnostic needle aspiration appears to be a factor in the improved survival rate of these patients.

    Original languageEnglish (US)
    Pages (from-to)127-131
    Number of pages5
    JournalThe American Journal of Surgery
    Volume150
    Issue number1
    DOIs
    StatePublished - Jul 1985

    ASJC Scopus subject areas

    • Surgery

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    Crass, R. A., Meyer, A. A., Jeffrey, R. B., Federie, M. P., Grendell, J. H., Wing, V. W., & Trunkey, D. D. (1985). Pancreatic abscess: Impact of computerized tomography on early diagnosis and surgery. The American Journal of Surgery, 150(1), 127-131. https://doi.org/10.1016/0002-9610(85)90021-2