Vascular complications in acute pancreatitis assessed by color duplex ultrasonography

We determined the sensitivity of computed tomography and color duplex ultra sonography in the detection and characterization of vascular complications in acute pancreatitis. The relationship of these complications with the eti ology and activity of the disease was assessed. In a prospective study, 189 patients with acute pancreatitis seen in the Department of Gastroenterolog y, Charite Hospital in Berlin over a period of 38 months underwent color du plex ultrasonography every second day for 3 weeks and thereafter at least o nce a week for 2 months. Dynamic computed tomography was performed within 7 2 hours after admission, and follow-up computed tomography scans were obtai ned. In 45 patients (23%), at least temporary thromboses of portal venous v essels were demonstrated by color duplex ultrasonography. The incidence of venous thromboses was 30% in severe acute pancreatitis with fluid collectio ns without necroses and 57% in necrotizing pancreatitis. In 27 of those 45 patients, a formation of collaterals was documented. In 13 patients, arteri al pseudoaneurysms were demonstrated. Vascular complications were significa ntly more frequent in alcohol-induced than in gallstone-induced pancreatiti s. Only 62% of all sonographically diagnosed thromboses and only 32% of all collaterals were demonstrated by computed tomography. The prevalence of va scular complications in acute pancreatitis was much higher as suspected. Th e risk of gastrointestinal bleeding was lower than previously reported. Col or duplex sonography is the method of choice for the detection of vascular complications in acute pancreatitis.