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

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Janneke van GrinsvenDutch Pancreatitis Study Group

Abstract

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. 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. 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 collection...Continue Reading

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Citations

Aug 18, 2020·Scandinavian Journal of Gastroenterology·Vasiliki Soulountsi, Theodoros Schizodimos
Oct 19, 2019·Journal of Clinical Medicine·Jorge PaulinoFilipe Veloso Gomes
Jan 23, 2021·Hepatobiliary & Pancreatic Diseases International : HBPD INT·He ZhangWei-Qin Li
Jan 21, 2021·Journal of Clinical Medicine·Robert DorrellRishi Pawa
Feb 18, 2021·Journal of Hepato-biliary-pancreatic Sciences·Lu KeUNKNOWN Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG)
Sep 4, 2020·American Journal of Surgery·Shravan Leonard-MuraliArielle H Gupta
May 15, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Henrik Leonard HusuPanu Juhani Mentula
Aug 3, 2021·Gastroenterology Research and Practice·Xiaowu Dong Chinese Acute Pancreatitis Clinical Trials Group Capctg
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Sep 7, 2020·Lancet·Lotte BoxhoornMarc G Besselink
Jun 14, 2019·Visceral Medicine·Mihailo BezmarevićMarc G Besselink

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