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Reevaluation of the Effect of Intravenous Contrast Medium on the Severity of Acute Pancreatitis

Tsann-Long Hwang, MD; Ken-Yuan Chang, MD; Yi-Ping Ho, MD

Arch Surg. 2000;135:287-290.

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 divided into 2 groups. Those in group A (n=10) underwent a CT examination with a contrast-enhanced medium, and those in group B (n=10) underwent a CT examination without a contrast-enhanced medium.

Main Outcome Measures  The patients' serum amylase, lipase, C-reactive protein, 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 biochemical 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 enzymes, C-reactive proteins, and leukocytes and in the biochemical data of either group before or after the CT examination. The difference in the previously examined values between the 2 groups was also not significant. There was also no difference in the morbidity, length of hospital stay, and mortality between the 2 groups.

Conclusion  Contrast-enhanced abdominal CT does not aggravate the severity of clinical patients with severe acute pancreatitis.

From the Departments of Surgery (Dr Hwang) and Gastroenterology (Drs Chang and Ho), Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.

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