Contrast-enhanced dynamic computed tomography does not aggravate the clinical severity of patients with severe acute pancreatitis - Reevaluation of the effect of intravenous contrast medium on the severity of acute pancreatitis
Tl. Hwang et al., Contrast-enhanced dynamic computed tomography does not aggravate the clinical severity of patients with severe acute pancreatitis - Reevaluation of the effect of intravenous contrast medium on the severity of acute pancreatitis, ARCH SURG, 135(3), 2000, pp. 287-290
Background: Contrast-enhanced abdominal computed tomography (CT) is useful
in demonstrating pancreatitis necrosis, but the administration of contrast
medium in animal models with acute pancreatitis may worsen the severity.
Hypothesis: The use of contrast-enhanced CT in clinical patients with acute
pancreatitis may actually aggravate the severity of the disease.
Design: A randomized prospective study.
Setting: Chang Gung Memorial Hospital, Taipei, Taiwan.
Patients: Twenty patients with severe acute pancreatitis were randomly divi
ded into 2 groups. Those in group A (n = 10) underwent a CT examination wit
h a contrast-enhanced medium,and those in group B (n = 10) underwent a CT e
xamination without a contrast-enhanced medium.
Main Outcome Measures: The patients' serum amylase, lipase, C-reactive prot
ein, leukocyte, glutamic-oxaloacetic transaminase, creatinine, calcium, and
phosphate levels were serially checked before the CT examination and at 2,
4, 6, 8, 12, and 24 hours after the examination was performed. The biochem
ical data between the 2 groups were compared. The morbidity, length of stay
, and mortality were also compared.
Results: There were no significant changes in the level of pancreatic enzym
es, C-reactive proteins, and leukocytes and in the biochemical data of eith
er group before or after the CT examination. The difference in the previous
ly examined values between the 2 groups was also not significant. There was
also no difference in the morbidity, length of hospital stay, and mortalit
y between the 2 groups.
Conclusion: Contrast-enhanced abdominal CT does not aggravate the severity
of clinical patients with severe acute pancreatitis.