Rapid-bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: A prospective study
The purpose of this prospective study was to determine the clinicopathological significance of necrotic areas demonstrated by rapid‐bolus contrast‐enhanced computed tomography (CT) in patients with biochemically predicted severe pancreatitis. Although CT necrosis occurred significantly more frequent...
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| Veröffentlicht in: | British journal of surgery 1991-12, Vol.78 (12), p.1452-1456 |
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| container_issue | 12 |
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| container_title | British journal of surgery |
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| creator | London, N. J. M. Leese, T. Watkin, D. F. L. Fossard, D. P. Lavelle, J. M. Miles, K. West, K. P. |
| description | The purpose of this prospective study was to determine the clinicopathological significance of necrotic areas demonstrated by rapid‐bolus contrast‐enhanced computed tomography (CT) in patients with biochemically predicted severe pancreatitis. Although CT necrosis occurred significantly more frequently in patients with clinically severe (ten of 12) compared with mild (seven of 20) pancreatitis (P < 0.025), seven of 17 (41 per cent) patients with CT necrosis developed clinically mild pancreatitis and six of ten (60 per cent) patients with clinically severe pancreatitis and CT necrosis recovered with conservative management. The site and extent of CT necrosis did not correlate with disease severity. Fine‐needle aspiration cytology, operative and post‐mortem findings and endoscopic retrograde cholangiopancreatography examinations all strongly suggested that CT necrosis represents true pancreatic necrosis. We conclude that the finding of CT necrosis is not in itself an indication for operative intervention, but that rapid‐bolus contrast‐enhanced dynamic CT greatly facilitates the planning and execution of surgical therapy. |
| doi_str_mv | 10.1002/bjs.1800781216 |
| format | Article |
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J. M. ; Leese, T. ; Watkin, D. F. L. ; Fossard, D. P. ; Lavelle, J. M. ; Miles, K. ; West, K. P.</creator><creatorcontrib>London, N. J. M. ; Leese, T. ; Watkin, D. F. L. ; Fossard, D. P. ; Lavelle, J. M. ; Miles, K. ; West, K. P.</creatorcontrib><description>The purpose of this prospective study was to determine the clinicopathological significance of necrotic areas demonstrated by rapid‐bolus contrast‐enhanced computed tomography (CT) in patients with biochemically predicted severe pancreatitis. Although CT necrosis occurred significantly more frequently in patients with clinically severe (ten of 12) compared with mild (seven of 20) pancreatitis (P < 0.025), seven of 17 (41 per cent) patients with CT necrosis developed clinically mild pancreatitis and six of ten (60 per cent) patients with clinically severe pancreatitis and CT necrosis recovered with conservative management. The site and extent of CT necrosis did not correlate with disease severity. Fine‐needle aspiration cytology, operative and post‐mortem findings and endoscopic retrograde cholangiopancreatography examinations all strongly suggested that CT necrosis represents true pancreatic necrosis. We conclude that the finding of CT necrosis is not in itself an indication for operative intervention, but that rapid‐bolus contrast‐enhanced dynamic CT greatly facilitates the planning and execution of surgical therapy.</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.1800781216</identifier><identifier>PMID: 1773324</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Bristol: John Wiley & Sons, Ltd</publisher><subject>Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Child ; Contrast Media ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Medical sciences ; Middle Aged ; Necrosis ; Pancreas - diagnostic imaging ; Pancreas - pathology ; Pancreatitis - diagnostic imaging ; Pancreatitis - pathology ; Pancreatitis - surgery ; Prospective Studies ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Tomography, X-Ray Computed</subject><ispartof>British journal of surgery, 1991-12, Vol.78 (12), p.1452-1456</ispartof><rights>Copyright © 1991 British Journal of Surgery Society Ltd.</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4346-50a9181acb87025a8675034c76d6a9ef6c6776378ce1e40124a84163782b8313</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.1800781216$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.1800781216$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5435741$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1773324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>London, N. J. M.</creatorcontrib><creatorcontrib>Leese, T.</creatorcontrib><creatorcontrib>Watkin, D. F. L.</creatorcontrib><creatorcontrib>Fossard, D. P.</creatorcontrib><creatorcontrib>Lavelle, J. M.</creatorcontrib><creatorcontrib>Miles, K.</creatorcontrib><creatorcontrib>West, K. P.</creatorcontrib><title>Rapid-bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: A prospective study</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>The purpose of this prospective study was to determine the clinicopathological significance of necrotic areas demonstrated by rapid‐bolus contrast‐enhanced computed tomography (CT) in patients with biochemically predicted severe pancreatitis. Although CT necrosis occurred significantly more frequently in patients with clinically severe (ten of 12) compared with mild (seven of 20) pancreatitis (P < 0.025), seven of 17 (41 per cent) patients with CT necrosis developed clinically mild pancreatitis and six of ten (60 per cent) patients with clinically severe pancreatitis and CT necrosis recovered with conservative management. The site and extent of CT necrosis did not correlate with disease severity. Fine‐needle aspiration cytology, operative and post‐mortem findings and endoscopic retrograde cholangiopancreatography examinations all strongly suggested that CT necrosis represents true pancreatic necrosis. We conclude that the finding of CT necrosis is not in itself an indication for operative intervention, but that rapid‐bolus contrast‐enhanced dynamic CT greatly facilitates the planning and execution of surgical therapy.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Contrast Media</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Necrosis</subject><subject>Pancreas - diagnostic imaging</subject><subject>Pancreas - pathology</subject><subject>Pancreatitis - diagnostic imaging</subject><subject>Pancreatitis - pathology</subject><subject>Pancreatitis - surgery</subject><subject>Prospective Studies</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Tomography, X-Ray Computed</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1991</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFUU1PHCEYJk2NrrZXbyZzaLyN5QUGWG9qqm1jNNFNNumFvMOwis6XA1M7_75sduOegOfrBR5CjoGeAaXse_kSzkBTqjQwkJ_IDLgs8rTVn8mMJjwHzvgBOQzhhVLgtGD7ZB-U4pyJGakesPdVXnb1GDLbtXHAEHPXPmNrXZVVU4uNt4lp-jEmIHZN9zRg_zxlvs3QJjDrk3ZwGH304Ty7yPqhC72z0f91WYhjNX0heyusg_u6XY_I4vrH4upnfnt_8-vq4ja3gguZFxTnoAFtqRVlBWqpCsqFVbKSOHcraaVSkittHThBgQnUAtYAKzUHfkRON7HpAm-jC9E0PlhX19i6bgxGMQkUCpGEJ1vhWDauMv3gGxwms_2VxH_b8hgs1qshPdCHD1lKKJRYz5tvZO--dtMuhZp1MyY1Y3bNmMvfj7tT8uYbrw_R_fvw4vBqpOKqMMu7G6OuxeJxKf6YJf8PmsmQpw</recordid><startdate>199112</startdate><enddate>199112</enddate><creator>London, N. J. M.</creator><creator>Leese, T.</creator><creator>Watkin, D. F. L.</creator><creator>Fossard, D. P.</creator><creator>Lavelle, J. M.</creator><creator>Miles, K.</creator><creator>West, K. P.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>199112</creationdate><title>Rapid-bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: A prospective study</title><author>London, N. J. M. ; Leese, T. ; Watkin, D. F. L. ; Fossard, D. P. ; Lavelle, J. M. ; Miles, K. ; West, K. P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4346-50a9181acb87025a8675034c76d6a9ef6c6776378ce1e40124a84163782b8313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1991</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Contrast Media</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Necrosis</topic><topic>Pancreas - diagnostic imaging</topic><topic>Pancreas - pathology</topic><topic>Pancreatitis - diagnostic imaging</topic><topic>Pancreatitis - pathology</topic><topic>Pancreatitis - surgery</topic><topic>Prospective Studies</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>London, N. J. M.</creatorcontrib><creatorcontrib>Leese, T.</creatorcontrib><creatorcontrib>Watkin, D. F. L.</creatorcontrib><creatorcontrib>Fossard, D. P.</creatorcontrib><creatorcontrib>Lavelle, J. M.</creatorcontrib><creatorcontrib>Miles, K.</creatorcontrib><creatorcontrib>West, K. P.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>London, N. J. M.</au><au>Leese, T.</au><au>Watkin, D. F. L.</au><au>Fossard, D. P.</au><au>Lavelle, J. M.</au><au>Miles, K.</au><au>West, K. P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rapid-bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: A prospective study</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>1991-12</date><risdate>1991</risdate><volume>78</volume><issue>12</issue><spage>1452</spage><epage>1456</epage><pages>1452-1456</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>The purpose of this prospective study was to determine the clinicopathological significance of necrotic areas demonstrated by rapid‐bolus contrast‐enhanced computed tomography (CT) in patients with biochemically predicted severe pancreatitis. Although CT necrosis occurred significantly more frequently in patients with clinically severe (ten of 12) compared with mild (seven of 20) pancreatitis (P < 0.025), seven of 17 (41 per cent) patients with CT necrosis developed clinically mild pancreatitis and six of ten (60 per cent) patients with clinically severe pancreatitis and CT necrosis recovered with conservative management. The site and extent of CT necrosis did not correlate with disease severity. Fine‐needle aspiration cytology, operative and post‐mortem findings and endoscopic retrograde cholangiopancreatography examinations all strongly suggested that CT necrosis represents true pancreatic necrosis. We conclude that the finding of CT necrosis is not in itself an indication for operative intervention, but that rapid‐bolus contrast‐enhanced dynamic CT greatly facilitates the planning and execution of surgical therapy.</abstract><cop>Bristol</cop><pub>John Wiley & Sons, Ltd</pub><pmid>1773324</pmid><doi>10.1002/bjs.1800781216</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Adolescent Adult Aged Aged, 80 and over Biological and medical sciences Child Contrast Media Humans Investigative techniques, diagnostic techniques (general aspects) Medical sciences Middle Aged Necrosis Pancreas - diagnostic imaging Pancreas - pathology Pancreatitis - diagnostic imaging Pancreatitis - pathology Pancreatitis - surgery Prospective Studies Radiodiagnosis. Nmr imagery. Nmr spectrometry Tomography, X-Ray Computed |
| title | Rapid-bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: A prospective study |
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