Peritoneal cavity circumference on computed tomography predicts outcomes in acute pancreatitis

We investigated the role of novel intra-abdominal parameters measured by computed tomography (CT) in the prediction of clinical outcomes in acute pancreatitis (AP). Patients with AP underwent an abdominal CT scan on admission to define different intra-abdominal parameters (abdominal circumference, p...

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Published in:European journal of radiology 2020-11, Vol.132, p.109327-109327, Article 109327
Main Authors: Monreal-Robles, Roberto, Kohn-Gutiérrez, Ana E., Sordia-Ramírez, José, Zúñiga-Segura, Julian A., Palafox-Salinas, Javier A., de la Rosa-Pacheco, Sylvia, Elizondo-Riojas, Guillermo, González-González, José A
Format: Article
Language:English
Subjects:
Abdominal obesity
Acute necrotizing pancreatitis
Adult
Female
Humans
Image Processing, Computer-Assisted
Intra-abdominal fat
Male
Mortality
Pancreatitis - diagnosis
Peritoneal Cavity - diagnostic imaging
Prospective Studies
Radiology
Severity of Illness Index
Tomography, X-Ray Computed
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Summary:We investigated the role of novel intra-abdominal parameters measured by computed tomography (CT) in the prediction of clinical outcomes in acute pancreatitis (AP). Patients with AP underwent an abdominal CT scan on admission to define different intra-abdominal parameters (abdominal circumference, peritoneal cavity circumference, intraabdominal visceral fat area, and subcutaneous fat area) at the L2-L3 level using the open-source image analysis software Osirix Lite v.11.0.4 to predict clinical outcomes. Eighty patients with AP were analyzed. Peritoneal cavity circumference (PCC) was the only variable independently associated with outcomes. PCC showed an area under ROC for prediction of severity in AP of 0.830. A PCC ≥ 85 cm increased the risk of severity of AP (RR 15.7), persistent systemic inflammatory response syndrome (RR 9.3), acute peripancreatic fluid collection (RR 6.4), necrotizing pancreatitis (RR 21.50), and mortality (RR 2.4). We found a 4.7-fold increase in the risk of developing severe AP for each 10 cm increase in PCC. PCC measurement at the L2-L3 level using a non-enhanced abdominal CT scan on admission in patients with AP is useful in the early prediction of severity, persistent systemic inflammatory response syndrome, local complications, and mortality.
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2020.109327