Early Detection of Acute Fulminant Pancreatitis by Contrast-Enhanced Computed Tomography

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Abstract
Twenty-eight consecutive patients with 1st attack of acute alcohol-induced pancreatitis were examined by computed tomography (CT). After a surgery scan of the abdomen a rapid contrast bolus (400 mg I/kg) was given i.v. and the contrast enhancement of the pancreatic parenchyma was measured from a consecutive series of pancreatic scans. Nine patients with a fulminant course of the disease were operated on and hemorrhagic necrotizing pancreatitis was found in 8. In all of these the contrast enhancement was decreased or absent. Patients recovering by conservative treatment showed normal or increased enhancement. The contrast enhancement seems to constitute a useful criterion for the early differentiation of acute fulminant pancreatitis from less severe forms of the disease.

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