Читать книгу Clinical Pancreatology for Practising Gastroenterologists and Surgeons - Группа авторов - Страница 56

Acute necrotic collections (ANCs) are collections containing a variable amount of liquid and solid tissue that arise during the initial four weeks of necrotizing pancreatitis. Necrosis involves only peripancreatic tissue in up to 50% of cases, which has more favorable outcomes compared to necrosis involving both the pancreatic parenchyma and peripancreatic tissue [23]. ANCs may appear poorly organized or loculated, disrupt fascial planes, and become infected. On CECT (Figure 3.3), ANCs contain varying amounts of solid necrotic tissue, though this may not be readily apparent until five to seven days after AP onset. The presence of gas is highly suggestive of infected necrosis. When in doubt, magnetic resonance imaging (MRI) may help confirm the presence of solid content. After more than four weeks, ANCs typically mature into walled‐off necrotic collections.

Figure 3.3 CECT showing acute necrotizing pancreatitis with an acute necrotic collection (ANC) involving both the pancreatic parenchyma and peripancreatic tissue (white arrows point to border of ANC). Note the heterogeneous appearance of liquid and solid contents within the ANC. There is extensive pancreatic necrosis (stars) with a small amount of normally enhancing tissue in the pancreatic tail (black arrow).

Source: courtesy of Peter A. Banks.