Influence of contrast-enhanced computed tomography on course and outcome in patients with acute pancreatitis

Many of the complications in severe acute pancreatitis result from the amplifying effects of microcirculatory disruption. Contrast medium may cause significant additional reductions of capillary flow, which has been shown to aggravate acute pancreatitis in experimental studies. To investigate the role of serial contrast-enhanced computed tomography (CECT) in patients with acute pancreatitis. A retrospective analysis evaluated 302 patients with moderate to severe acute pancreatitis. Among these patients, 264 underwent CECT within 96 hours of the onset of symptoms and again during the course, but in 38 patients no serial CECT was performed. Outcome measurement was analyzed by comparison of hospital stay and mortality rate between the two patient groups. Influences of contrast medium on severity of disease were detected by monitoring complications during the course of treatment, C-reactive protein, and APACHE II score. The 1-month mortality rate was less in patients with CECT (6.4% versus 15.8%, p