Galarraga D, García N, Barrios S, Hinestrosa H, Quiróz E
Servicio de Gastroenterología, Hospital Domingo Luciani del IVSS, Caracas.
G E N. 1992 Apr-Jun;46(2):93-101.
As acute pancreatitis is a disease of unpredictable outcome, we wanted to use an available diagnostic method such as ultrasonography, in order to establish the prognosis of this problem. There are some published papers using CT scan as prognostic value of this disease but none about ultrasonography. We evaluated 34 patients with clinical diagnosis of acute pancreatitis based on abdominal pain, nausea, vomits and absence of abdominal sounds plus an elevation of amylases of at least three times above the normal value. An abdominal ultrasound was performed at admission and every 4 days or even sooner if complications were suspected. Acute pancreatitis was classified by clinic and ultrasound in mild, moderate and severe. From 34 patients studied, 27 were clinically and by ultrasound correlated (79%) giving a sensibility of 100% and a specificity of 85%, without false positives. There were some cases in which ultrasound detected abnormalities before clinical manifestations, so a close follow up was done and this allowed us to be ready if any complications showed up. Follow up with ultrasound examination was very useful, permitted us to detect early complications with or without clinical manifestations and also emphasized that a single ultrasound examination is not enough as a prognostic or diagnostic method.
由于急性胰腺炎是一种预后难以预测的疾病，我们希望使用超声检查这种现有的诊断方法来确定该疾病的预后。有一些已发表的论文将CT扫描用作该疾病的预后评估指标，但关于超声检查的却没有。我们评估了34例临床诊断为急性胰腺炎的患者，这些患者均有腹痛、恶心、呕吐症状，肠鸣音消失，且淀粉酶升高至少为正常值的三倍以上。入院时进行腹部超声检查，此后每4天检查一次，若怀疑有并发症则检查更频繁。根据临床症状和超声检查结果，将急性胰腺炎分为轻度、中度和重度。在研究的34例患者中，27例临床症状与超声检查结果相符（79%），敏感性为100%，特异性为85%，无假阳性。有一些病例中，超声检查在临床表现出现之前就检测到了异常情况，因此进行了密切随访，这样一旦出现任何并发症我们就能做好准备。超声检查随访非常有用，使我们能够检测出有无临床表现的早期并发症，同时也强调了单次超声检查作为预后或诊断方法是不够的。
