Infected pancreatic necrosis

Bassi, Claudio

doi:10.1007/bf02925603

Cited by 37 publications

(1 citation statement)

References 49 publications

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“…Severe necrotizing pancreatitis is associated with high mortality rates of 30% to 40% [2]. The majority of the death in the initial phase of this disease is due to multiple organ failure; however, the local and systemic infectious complications play a significant role in the mortality in the later phase [3]. The mortality associated with necrotizing pancreatitis is less than 10% if the necrotic tissue remains sterile [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Diffusion-Weighted Magnetic Resonance Imaging Is an Ideal Imaging Method to Detect Infection in Pancreatic Collections: A Brief Primer for the Gastroenterologists

Sureka¹,

Rai²,

Varshney³

et al. 2022

Cureus

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Background: The development of infection in pancreatitis significantly increases the mortality rate up to 100% in the absence of any intervention. Therefore, it is extremely important to diagnose these cases at an early stage. The objectives of this study were to assess the diagnostic performance of computed tomography (CT) and diffusion-weighted MR imaging (DW-MRI) in the diagnosis of infection in pancreatic collections.Materials and methods: Prospective observational study of abdominal collections due to pancreatitis that underwent both CT and DW-MRI from August 2018 to July 2020 were enrolled in the study. The collections were analysed for infections -air foci in CT and diffusion restriction on DW-MRI.Results: Of the 39 patients recruited in the study, infected collections were present in 17, and 22 cases had sterile collections. On CT, air foci within the collection were present only in seven of the cases in our study (sensitivity 35%, specificity 95.4%, PPV 85.7%, NPV 65.6%). DW-MRI detected infection in all 17 cases (sensitivity 100%, specificity 72.7%, PPV 74%, NPV 100%).Discussion: Thirteen out of 17 collections suspicious for infection on DW-MR showed microbiological growth on culture examination. We believe that this is likely due to the patient's prior antibiotic use, which might have altered the micro-environment or inflammatory cell and bacterial content of the collection. Conclusion: DW-MRI is complementary and superior to CT in detecting infection in pancreatic collections. CT may be used to detect disease burden, extent and vascular complication.

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