PLEURAL EFFUSION AS A PREDICTOR OF SEVERITY IN ACUTE-PANCREATITIS

Our objective was to determine whether pleural effusion is a predictor of severity in acute pancreatitis and, if so, whether it is an indepe ndent predictor. One hundred ninety six consecutive cases of acute pan creatitis from October 1, 1994, to September 30, 1995, were reviewed. Medical records were analyzed for evidence of pleural effusion by ches t radiograph and severe acute pancreatitis by identification of pancre atic necrosis or organ system dysfunction. Data were analyzed to deter mine if identification of pleural effusion provided an early sign of s everity. Among 135 patients who underwent chest radiography, pleural e ffusion was seen in 16 of 19 (84.2%) with severe pancreatitis and 10 o f 116 (8.6%) of patients with mild pancreatitis (p < 0.001). Pleural e ffusion was noted in severe pancreatitis prior to clinical or computed tomography evidence of severity in only 20% of cases. Pleural effusio n is strongly associated with severity in acute pancreatitis but provi des independent information on severity in only a minority of cases.