Radiology, Vol 155, 335-340, Copyright © 1985 by Radiological Society of North America
Complicated pancreatic inflammatory disease: diagnostic and therapeutic role of interventional radiology
E vanSonnenberg, GR Wittich, G Casola, AE Stauffer, AD Polansky, HG Coons, OA Cabrera and PS Gerver
Diagnostic and therapeutic interventional radiology techniques in 41
patients with complications of pancreatic inflammatory disease (noninfected
pseudocyst, infected pseudocyst, phlegmon, abscess, hemorrhagic
pancreatitis) are described. Computed tomography or ultrasound-guided
aspiration or percutaneous pancreatic ductography enabled specific
diagnoses in 43 of 45 patients (96%). In almost half the patients,
diagnostic aspiration with 22-gauge needles was unsuccessful due to viscous
contents or firm cavity walls. Single-step needle aspiration of noninfected
pseudocysts was successful in only three of ten patients (30%). Catheter
drainage cured six of seven noninfected pseudocysts (85.7%) and seven of
nine infected pseudocysts (77.7%). Pancreatic phlegmons were aspirated in
five patients to exclude secondary infection and help determine the need
for surgery. Pancreatic abscesses were drained successfully in nine of 13
patients (69.2%); temporizing benefit was achieved in the other four who
eventually underwent surgery in improved condition. Early diagnosis of the
complications of pancreatitis may be established almost uniformly, and at
least 70% of patients with infected or noninfected pseudocysts and
pancreatic abscesses may be cured by nonoperative drainage.
