Blinder G, Hiller N, Fisher D, Hadas-Halpren I
Dept. of Radiology, Shaare Zedek Medical Center, Jerusalem.
Harefuah. 1996 May 15;130(10):657-62, 728.
Acute pancreatitis is a multifaceted disease as expressed by its multiple etiologies, varying clinical presentations, radiological appearances and pathological changes. This variability has lead to a confusing range in terminology that has complicated the precise classification of this entity. A uniform interdisciplinary classification is necessary to facilitate assessment of acute pancreatitis. An international symposium held in 1992, attended by experts in fields including surgery, radiology, and pathology, formulated a nomenclature to describe acute pancreatitis. We retrospectively studied 96 cases of acute pancreatitis to test the efficacy of this classification as regards severity of the disease process and its complications. The initial severity of the pancreatitis was assessed, complications and their treatment noted and the various imaging modalities and their indications reviewed. The most efficacious investigation was computed tomography with intravenous contrast injection. Good correlation with the newer classification was noted in assessing the severity of the illness and its complications, as well as aiding in interdisciplinary communication. Particular difficulty was noted differentiating infected necrosis, pancreatic abscess and infected psuedocysts. Our results correlate well with the current literature, with the exception of a higher relative incidence of pancreatitis among females. This probably reflects the lower incidence of alcoholism in Israel among men, with biliary lithiasis among females primary in the etiology of the disease.
急性胰腺炎是一种多方面的疾病，这体现在其多种病因、不同的临床表现、影像学表现和病理变化上。这种变异性导致了术语的混乱，使该疾病实体的精确分类变得复杂。统一的跨学科分类对于促进急性胰腺炎的评估是必要的。1992年举行了一次国际研讨会，外科、放射学和病理学等领域的专家参加了会议，制定了描述急性胰腺炎的命名法。我们回顾性研究了96例急性胰腺炎病例，以测试这种分类在疾病进程严重程度及其并发症方面的有效性。评估了胰腺炎的初始严重程度，记录了并发症及其治疗情况，并回顾了各种成像方式及其适应症。最有效的检查是静脉注射造影剂的计算机断层扫描。在评估疾病严重程度及其并发症以及有助于跨学科交流方面，与新分类法有良好的相关性。在区分感染性坏死、胰腺脓肿和感染性假性囊肿方面存在特别困难。我们的结果与当前文献相关性良好，但女性胰腺炎的相对发病率较高除外。这可能反映了以色列男性酗酒发生率较低，而女性中胆石症是该疾病病因中的主要因素。
