Ischemic penumbra in early stage of severe acute pancreatitis

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  • TSUJI Yoshihisa
    Department of Gastroenterology and Hepatology, Kyoto University Hospital Department of Radiology, Kurashiki Central Hospital
  • WATANABE Tsubasa
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • SHIOKAWA Masahiro
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • UZA Norimitsu
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • KODAMA Yuzo
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • WATANABE Yuji
    Department of Radiology, Kurashiki Central Hospital
  • YAMAMOTO Hiroshi
    Department of Gastroenterology, Kurashiki Central Hospital
  • KOIZUMI Koji
    Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital
  • CHIBA Tsutomu
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • ISODA Hiroyoshi
    Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Hospital
  • KURITA Akira
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • SAWAI Yugo
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • UENO Kenji
    Department of Gastroenterology and Hepatology, Kyoto University Hospital
  • SHIO Seiji
    Department of Gastroenterology and Hepatology, Kyoto University Hospital

Bibliographic Information

Other Title
  • 重症急性膵炎発症早期における″可逆性－非可逆性膵虚血″の診断
Published
2011
DOI
  • 10.2958/suizo.26.59
Publisher
Japan Pancreas Society

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Description

Introduction: We investigated the existence of an ischemic penumbra, which indicates ischemic but still viable lesion, in the early stage of severe acute pancreatitis (SAP).<br> Methods: Seventy-one consecutive patients with SAP were enrolled. We divided the pancreas into three regions, the head, body and tail, and measured pancreatic blood flow(FV) and volume(VD) in each region by perfusion CT with one compartment method within three days after the onset of symptoms. Three weeks later, all patients underwent contrast-enhanced CT to diagnose each region for the development of pancreatic necrosis.<br> Results: Of the 227 pancreatic regions from 71 SAP patients, 30 regions were diagnosed as positive for pancreatic necrosis. FV and VD in regions that developed pancreatic necrosis were significantly lower than those in regions without necrosis (35.7±50.7 vs. 197.0±227.6ml/min, p<0.01 and 2.0±2.6 vs. 8.5±8.8 (%), p<0.01). All 19 regions with FV <37.5ml/min and VD <3.4% developed pancreatic necrosis. Of 60 regions with FV ≥37.5ml/min and VD <3.4%, 7 (11.7%) developed necrosis and of 7 regions with FV <37.5ml/min and VD ≥3.4%, 4 (11.7%) developed necrosis. None of 141 regions with FV ≥37.5ml/min and VD ≥3.4% developed necrosis.<br> Discussion: If FV or VD was low, not all regions developed pancreatic necrosis; therefore, we considered that these regions could include zones of ischemic penumbra.<br>

Journal

  • Suizo

    Suizo 26 (1), 59-65, 2011

    Japan Pancreas Society

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