ACUTE-PANCREATITIS IN CHILDREN - CT FINDINGS OF INTRAPANCREATIC AND EXTRAPANCREATIC FLUID COLLECTIONS

PURPOSE: To determine the location and importance of fluid collections in children with acute pancreatitis. MATERIALS AND METHODS: The autho rs retrospectively reviewed the abdominal computed tomographic (CT) sc ans of 28 children with acute pancreatitis. CT scans were evaluated fo r pancreatic size and distribution of intra- and extrapancreatic fluid collections. Extrapancreatic fluid was classified as (a) peritoneal, (b) retroperitoneal, (c) mesenteric, or (d) ligamentous. RESULTS: Four teen children (50%) had complicated pancreatitis associated ed with fl uid collections. Intrapancreatic fluid was identified in only two pati ents (7%), whereas extrapancreatic fluid was seen in 14 (50%). Extrapa ncreatic fluid was most often seen in the anterior pararenal space, fo llowed by the lesser sac, lesser omentum, and transverse mesocolon. Th e fluid collections diminished spontaneously in 11 patients (78%). Thr ee patients with persistent fluid collections required surgical interv ention for associated abnormalities. CONCLUSION: Intrapancreatic fluid collections are rare in children with pancreatitis. Extrapancreatic f luid collections tend to be extensive, but most diminish spontaneously .