Abstract
Objective:To investigate the values of Computed Tomography (CT) in diagnosing postoperative pancreatic surgeryabdominalinfection and its efficacy and to provide a reasonable method for the diagnosis of abdominal infection.Methods:Seventy-two patients who were confirmed as resectablepancreatic carcinoma by physical examination, CT, positron emission tomography (PET)/CT, endoscopic retrograde cholangiopancreatography (ER-CP), endoscopic ultrasonography and mesenteric angiography and were admitted to the Binzhou People’s Hospital, Shandong, China, from July 2013 to July 2015 were randomly selected. The plain CT images and clinical data of the patients were retrospectively analyzed.Results:Among 72 patients, 32 patients were diagnosed as abdominal infection by CT, three patients were misdiagnosed (two cases of intestinal obstruction and one case of intraperitoneal abscess), and 2 patients were wrongly diagnosed as suppurative abdominal inflammation. As regards distribution of CT imaging positive performance, the number of patients with intestinal loop abscess accounted for 41.7%, subphrenic abscess for 16.7%, pelvic abscess for 33.3%, the existence of septation for 25%, and emphysema sign for 16.7%. As to the distribution of CT findings of intestinal obstruction, 46.1% of patients had dilatation of intestine, 30.8% for bowel wall thickening, 7.7% had abnormal enhancement, 11.1% had density abnormality, and 15.4% had mesenteric effusion. CT features of purulent peritonitis showed 57.1% of patients had peritoneal thickening, 42.9% had peritoneal effusion, 42.9% had free intraperitoneal air, 14.3% had intestinal walls edema, and 28.6% had mesenteric edema.Conclusion:The diagnosis of postoperative abdominal infection of patients with pancreatic carcinoma using CT is quick and efficient showing the pattern and distribution of collection and the gross reaction to the exciting infection.
Highlights
Pancreatic carcinoma is one of the commonly seen malignant tumors in the digestive system and one of the malignant tumors with poor outcome
All the patients had no organ infection, diabetes, hypertension and cardiacerebrovascular disease before surgery. They were confirmed as pancreatic carcinoma by physical examination, computed tomography (CT), positron emission tomography (PET)/CT, endoscopic retrograde cholangiopancreatography (ER-CP), endoscopic ultrasonography and mesenteric angiography
CT diagnostic coincidence rate: Among 72 patients with pancreatic carcinoma, 32 patients were confirmed as abdominal infection by one[1] case of intraperitoneal abscess; two cases were wrongly diagnosed as purulent peritonitis
Summary
Pancreatic carcinoma is one of the commonly seen malignant tumors in the digestive system and one of the malignant tumors with poor outcome. Patients with pancreatic carcinoma show no obvious specific performance but clinical symptoms such as abdominal pain, jaundice, anorexia, body mass. For patients with pancreatic carcinoma, suboptimal nursing can induce postoperative abdominal infection, which can further lower the survival rate of patients.[5] The postoperative complications of patients with pancreatic carcinoma mainly include abscess shock and multiple organ failure, which can severely affect the quality of life of patients after surgery.[6,7] the accurate diagnosis of operation induced abdominal infection in the early stage is of great significance
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