Abdominal Radiology

, Volume 42, Issue 4, pp 1199–1209 | Cite as

The diagnostic challenge of the sequelae of acute pancreatitis on CT imaging: a pictorial essay

  • Mark Hughey
  • Myles Taffel
  • Robert K. Zeman
  • Smita Patel
  • Michael C. Hill
Pictorial Essay

Abstract

Purpose

The purpose of the study was to present a pictorial review of the long-term sequelae of acute pancreatitis on CT imaging as these findings can cause diagnostic confusion in the absence of a proper clinical history and/or prior CT imaging.

Methods

We retrospectively identified 81 patients who had an episode of acute pancreatitis with diagnostic findings on CT and also underwent one or more follow-up CT scans at least 1 month beyond the acute episode. The residual findings on all follow-up CT scans were tabulated, including the time interval since the initial bout of acute pancreatitis.

Result

Residual inflammatory changes were present in 19.8% of cases, with a median time period lasting 86 days since the initial episode of acute pancreatitis. Residual fluid collections were seen in 27.2% and persisted for a median of 132 days. Three patients had residual solid-appearing inflammatory masses, which could be mistaken for neoplasms. Other long-term sequelae were also tabulated, including pancreatic ductal dilatation, pancreatic atrophy, new or increased pancreatic calcifications, biliary tract dilatation, central portal venous occlusion, and pseudoaneurysm formation. These residual findings and long-term complications are presented as a pictorial essay.

Conclusion

Recognizing the spectrum of residual findings of acute pancreatitis, some of which can be long term, is important in the correct interpretation of a pancreatic CT. These findings can mimic acute pancreatitis or a pancreatic/peripancreatic neoplasm and often cause diagnostic confusion, especially in the absence of prior CT imaging.

Keywords

Acute pancreatitis Chronic pancreatitis Pseudocyst Residual peripancreatic inflammation Residual fluid collections Computed tomography (CT) 

Notes

Acknowledgements

We wish to thank Dr. Gavin Gore M.D. and Dr. Anshu Shukla M.D. for the research they performed in preparation of this pictorial essay.

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of RadiologyGeorge Washington University HospitalWashingtonUSA

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