Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 29;24(1):53.
doi: 10.1186/s12876-024-03145-7.

Early encapsulation of peripancreatic fluid/necrosis collections on imaging (CECT) in acute pancreatitis: influential factors and clinical significance for prognosis

Ning Ning #  1 , Congyi Yu #  1 , Wenwu Sun #  1 , Yi Wen  1 , Tongtian Ni  1 , Huiqiu Sheng  1 , Ying Chen  1 , Li Ma  1 , Erzhen Chen  1 , Bing Zhao  2 , Enqiang Mao  3
Affiliations

Early encapsulation of peripancreatic fluid/necrosis collections on imaging (CECT) in acute pancreatitis: influential factors and clinical significance for prognosis

Ning Ning et al. BMC Gastroenterol. .

Abstract

Background: To identify the factors influencing the early encapsulation of peripancreatic fluid/necrosis collections via contrast-enhanced computed tomography (CECT) and to determine the clinical significance of early encapsulation for determining the prognosis of acute pancreatitis (AP) patients.

Methods: AP patients who underwent CECT between 4 and 10 days after disease onset were enrolled in this study. Early encapsulation was defined as a continuous enhancing wall around peripancreatic fluid/necrosis collections on CECT. Univariate and multivariate logistic regression analyses were performed to assess the associations between the variables and early encapsulation. Clinical outcomes were compared between the non-encapsulation and early encapsulation groups with 1:1 propensity score matching.

Results: A total of 289 AP patients were enrolled. The intra-observer and inter-observer agreement were considered good (kappa statistics of 0.729 and 0.614, respectively) for identifying early encapsulation on CECT. The ratio of encapsulation increased with time, with a ratio of 12.5% on day 5 to 48.7% on day 9. Multivariate logistic regression analysis revealed that the longer time from onset to CECT examination (OR 1.55, 95% CI 1.23-1.97), high alanine aminotransferase level (OR 0.98, 95% CI 0.97-0.99), and high APACHE II score (OR 0.89, 95% CI 0.81-0.98) were found to be independent factors associated with delayed encapsulation. The incidence of persistent organ failure was significantly lower in the early encapsulation group after matching (22.4% vs 6.1%, p = 0.043). However, there was no difference in the incidence of infected pancreatic necrosis, surgical intervention, or in-hospital mortality.

Conclusions: AP patients without early encapsulation of peripancreatic fluid/necrosis collections have a greater risk of persistent organ failure. In addition to longer time, the high APACHE II score and elevated alanine aminotransferase level are factors associated with delayed encapsulation.

Keywords: Acute pancreatitis; Contrast-enhanced computed tomography; Infection; Organ failure; Risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Axial contrast-enhanced CT scans in acute pancreatitis patients. A, B with encapsulation; C, D: without encapsulation. A 52-year-old woman on day 5 after symptom onset; (B) 71-year-old man on day 9 after symptom onset; (C) 59-year-old woman on day 8 after symptom onset; (D) 49-year-old man on day 9 after symptom onset. Arrowheads denote the encapsulation around the peripancreatic fluid/necrosis collections
Fig. 2
Fig. 2
Flow diagram of participant selection in the study. AP: acute pancreatitis; CECT: contrast-enhanced computed tomography
Fig. 3
Fig. 3
The percentage of early encapsulation on CECT at the given day. CECT: contrast-enhanced computed tomography
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Boxhoorn L, Voermans RP, Bouwense SA, et al. Acute pancreatitis. Lancet (London, England) 2020;396:726–734. doi: 10.1016/S0140-6736(20)31310-6. - DOI - PubMed
    1. Xiao AY, Tan ML, Wu LM, et al. Global incidence and mortality of pancreatic diseases: a systematic review, meta-analysis, and meta-regression of population-based cohort studies. Lancet Gastroenterol Hepatol. 2016;1:45–55. doi: 10.1016/S2468-1253(16)30004-8. - DOI - PubMed
    1. Yasuda H, Horibe M, Sanui M, et al. Etiology and mortality in severe acute pancreatitis: a multicenter study in Japan. Pancreatology. 2020;20:307–317. doi: 10.1016/j.pan.2020.03.001. - DOI - PubMed
    1. Schepers NJ, Bakker OJ, Besselink MG, et al. Impact of characteristics of organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut. 2019;68:1044–1051. doi: 10.1136/gutjnl-2017-314657. - DOI - PubMed
    1. Yokoe M, Takada T, Mayumi T, et al. Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015. J Hepatobiliary Pancreat Sci. 2015;22:405–432. doi: 10.1002/jhbp.259. - DOI - PubMed

Substances