Mo1340 Does the Site of Fluid Collection Alter the Clinical Course of Acute Pancreatitis? -A Prospective Observational Study

Abstract

G A A b st ra ct s clear. Methods: Consecutive patients with symptomatic WOPN seen over last 7 months were prospectively included in the study. All the patients underwent EUS, MRI and abdominal ultrasoundwithin two days. On each of these investigations an attemptwas made to determine the site, size and the nature of contents of the WOPN. The echogenic material seen in the collection on EUS and abdominal ultrasound was considered as necrotic debris. On MRI, the hypo intense areas inside the collection on T2 weighted images were taken as solid debris. The solid debris was quantified by two independent observers for all three imaging modalities and the mean was taken as final value. Results: A total of 21 patients were included. There were 16 males (78.9%) and the mean age was 43.5 ± 11.13 years. The etiology was alcohol in 13 and gall stones in 6 patients. The imaging (EUS, MRI and abdominal ultrasound) was done at a mean of 12 ± 13.93 weeks of onset of abdominal pain. On EUS, 8 patients had a solid content of ≤10%, 11 had a content of 10-40% and 2 patients had a solid content of >40%. On MRI, 10 patients were noted to have a solid content of ≤10%, 9 patients had a solid content >10-40% and 2 had content of >40%. On abdominal ultrasound 9 patients had a content of ≤10% while nine patients had a solid content between 10-40%. WON could not be visualized on abdominal ultrasound in 3 patients, two of whom had a high content of solid debris on EUS/MRI. All patients in whom the collections were not visualized on abdominal ultrasound had presented within 6 weeks of onset of disease. All patients with disease duration of >6 weeks had WOPN well visualized on abdominal ultrasound. Conclusion: Trans abdominal ultrasound can help in diagnosis as well as characterization of majority of WOPN collections with comparable accuracy as that of EUS/MRI. However, collections early in the course of disease and with high content of solid debris may be difficult to evaluate on abdominal ultrasound.