Acute pancreatitis in children: CT findings of intra- and extrapancreatic fluid collections.

Abstract

PURPOSE: To determine the location and importance of fluid collections in children with acute pancreatitis. MATERIALS AND METHODS: The authors retrospectively reviewed the abdominal computed tomographic (CT) scans of 28 children with acute pancreatitis. CT scans were evaluated for 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: Fourteen children (50%) had complicated pancreatitis associated with fluid collections. Intrapancreatic fluid was identified in only two patients (7%), whereas extrapancreatic fluid was seen in 14 (50%). Extrapancreatic fluid was most often seen in the anterior pararenal space, followed by the lesser sac, lesser omentum, and transverse mesocolon. The fluid collections diminished spontaneously in 11 patients (78%). Three patients with persistent fluid collections required surgical intervention for associated abnormalities. CONCLUSION: Intrapancreatic fluid collections are rare in children with pancreatitis. Extrapancreatic fluid collections tend to be extensive, but most diminish spontaneously.