Akut peripankreatik sıvı koleksiyonu

Özet

APFC, interstisyel ödemli pankreatit sırasında pankreas çevresindeki erken, basit sıvı koleksiyonudur. BT’de fasiyal planlarla sınırlı homojen sıvı görünür; duvar ve nekrotik katı içerik beklenmez. Bu terim, akut nekrotik koleksiyon veya olgun psödokistle karıştırılmamalıdır. İçerikte debris ya da kapsül gelişimini kaçırmak Atlanta adlandırmasını değiştirir.

Faz ve pencere

Portal tanısal

Pankreas dışı peripankreatik fasya düzlemlerinde homojen sıvı dansitesi, belirgin çevresel duvar olmadan görülür; içte yumuşak doku yoğunluklu nekrotik debris olmamalıdır.

Kontrastsız

Kontrastsız BT'de sıvı ile kontrastlanan pankreas parankimi veya damarlar arasındaki ayırım zor olabilir; bu nedenle koleksiyonun karakterizasyonu ve nekroz değerlendirmesi için kontrastlı BT tercih edilmelidir.

Önerilen pencereler: Batın (G 400 / M 50), Karaciğer (G 150 / M 30).

BT bulguları

• İnterstisyel ödemli pankreatite eşlik eden, çoğunlukla pankreas dışındaki basit sıvı
• Homojen sıvı atenüasyonu; belirgin solid veya yağ yoğunluklu debris yok
• İnflamasyonun yayılımına göre lesser sac, anterior pararenal alan veya pankreas çevresinde fasiyal sınırları izler
• Belirgin kapsül/duvar gelişmemiştir
• Koleksiyon içinde gaz bulunması APFC için tipik değildir; enfeksiyon, fistül veya girişim olasılığını açar
• APFC, interstisyel ödemli pankreatitle ilişkili, başlangıçtan sonraki ilk dört haftada görülen, homojen sıvı içerikli ve belirgin duvarı olmayan koleksiyondur; nekrotizan pankreatitteki debris içeren erken koleksiyon ANC olarak adlandırılır.

Ölçütler ve sınıflamalar

APFC zaman tanımı

İnterstisyel ödemli pankreatit başlangıcından sonraki ilk 4 hafta

Revize Atlanta sınıflaması

İnterstisyel ödemli tipte parankim homojen kontrastlanır ve nekroz yoktur; nekrotizan tipte pankreatik ve/veya peripankreatik nekroz bulunur. Koleksiyonlar içerik ve kapsül durumuna göre APFC, psödokist, ANC veya WON olarak adlandırılır.

Normalde

APFC, retroperitoneumun normal anatomik planlarıyla sınırlanır. Kontrastlı BT’de koleksiyonun normal retroperitoneal anatomik planlarla sınırlı, homojen sıvı yoğunluğunda ve duvarsız olup olmadığını; ayrıca solid içerik bulunup bulunmadığını değerlendir.

Ayırıcı tanı

Akut nekrotik koleksiyon

heterojen sıvı ve katı nekrotik debris içerir, çoğunlukla nekrotizan pankreatitle birliktedir.

Psödokist

homojen sıvı olsa da iyi sınırlı olgun duvarı vardır ve daha geç dönemde gelişir.

Asit

bağımlı peritoneal aralıklara yayılır; pankreas çevresi tek fasiyal kompartımanda sınırlı değildir.

Tuzaklar

• Erken koleksiyon henüz organize olmadığı için sınırları belirsiz olabilir; “duvar yok” bulgusu tek başına sıvı olmadığını göstermez.
• İlk 1–2 haftada APFC ile ANC’yi görüntülemede ayırt etmek güç olabilir; bu dönemde her ikisi de solid bileşen olmaksızın sıvı dansitesinde görünebilir.

Kendini dene

1. Akut pankreatit başlangıcından kısa süre sonra görülen, homojen sıvı atenüasyonlu, duvarsız ve debris içermeyen peripankreatik koleksiyon hangisidir?

   • APFC
   • Psödokist
   • ANC
   • WON
   Cevabı göster

   APFC. APFC, interstisyel ödemli pankreatitte erken gelişen, duvarı ve nekrotik içeriği olmayan homojen koleksiyondur.

2. Akut pankreatitin ilk 4 haftasında, nekrotizan pankreatitle ilişkili ve katı nekrotik debris içeren koleksiyon hangi adla sınıflandırılır?

   • Akut peripankreatik sıvı koleksiyonu (APFC)
   • Akut nekrotik koleksiyon (ANC)
   • Psödokist
   • Walled-off nekroz (WON)
   Cevabı göster

   Akut nekrotik koleksiyon (ANC). Nekrotizan pankreatitle ilişkili, ilk 4 haftada görülen ve katı nekrotik bileşenler içerebilen koleksiyon ANC olarak adlandırılır.

İlgili konular

• Akut nekrotik koleksiyon

Kaynaklar

Bu sayfadaki 32 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 4 cümle bu karşılaştırmada düzeltildi (2026-10-09).

1. Imaging lexicon for acute pancreatitis: 2012 Atlanta Classification revisitedpmc.ncbi.nlm.nih.gov
2. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis *pmc.ncbi.nlm.nih.gov
3. Isolated Blunt Pancreatic Head Injury with Evolving Acute Peripancreatic Fluid Collection in a Child Successfully Managed Conservativelypmc.ncbi.nlm.nih.gov
4. Hypertriglyceridemia‑Induced Acute Pancreatitis Compared With Non‐Hypertriglyceridemia Acute Pancreatitis: A Retrospective Case‐Control Studypmc.ncbi.nlm.nih.gov
5. Clinical and CT/MRI imaging features of acute pancreatitis in older peoplepmc.ncbi.nlm.nih.gov
6. Fluid collections associated with acute pancreatitis: a pictorial essay.pubmed.ncbi.nlm.nih.gov
7. Updated imaging nomenclature for acute pancreatitis.pubmed.ncbi.nlm.nih.gov
8. Walled-off pancreatic necrosis and other current concepts in the radiological assessment of acute pancreatitis.pubmed.ncbi.nlm.nih.gov
9. Imaging of acute pancreatitis and its complications. Part 2: complications of acute pancreatitis.pubmed.ncbi.nlm.nih.gov
10. Advances in the endoscopic management of pancreatic collections.pubmed.ncbi.nlm.nih.gov
11. [Acute pancreatitis : Typical findings in computed tomography and magnetic resonance imaging].pubmed.ncbi.nlm.nih.gov
12. Diagnosis of Acute Pancreatitis Using Postmortem Computed Tomography and Postmortem Magnetic Resonance Imaging: A Case Report and a Review of Literature.pubmed.ncbi.nlm.nih.gov
13. Acute Pancreatitis Classifications: Basis and Key Goals.pubmed.ncbi.nlm.nih.gov
14. Drug-induced acute pancreatitis: Prevalence, Causative agents, and Outcomes.pubmed.ncbi.nlm.nih.gov
15. MR Imaging for Early Extrapancreatic Necrosis in Acute Pancreatitis.pubmed.ncbi.nlm.nih.gov
16. Peritoneal cavity circumference on computed tomography predicts outcomes in acute pancreatitis.pubmed.ncbi.nlm.nih.gov
17. Imaging lexicon for acute pancreatitis: 2012 Atlanta Classification revisited.pubmed.ncbi.nlm.nih.gov
18. Urinary trypsinogen-2 level and local complications of acute pancreatitis.pubmed.ncbi.nlm.nih.gov
19. Retroperitoneal abscess and acute acalculous cholecystitis after iatrogenic colon injury: report of a case.pubmed.ncbi.nlm.nih.gov
20. Clinical and CT/MRI imaging features of acute pancreatitis in older people.pubmed.ncbi.nlm.nih.gov
21. Deep learning-based detection of acute pancreatitis on abdominal contrast-enhanced CT.pubmed.ncbi.nlm.nih.gov
22. Drinking Patterns and CT/MRI Feature-Based Nomogram Models Can More Accurately Predict Acute Alcoholic Pancreatitis Recurrence.pubmed.ncbi.nlm.nih.gov
23. Walled-Off Pancreatic Necrosis Mimicking a Pancreatic Pseudocyst: A Diagnostic Pitfall With Therapeutic Implications.pubmed.ncbi.nlm.nih.gov
24. Beyond the Six-Week Rule: Contemporary Insights Into Pancreatic Pseudocyst.pubmed.ncbi.nlm.nih.gov
25. Recognition of a Sausage-Shaped Pancreas on Non-contrast Computed Tomography as an Early Clue to Type 2 Autoimmune Pancreatitis in a Young Adult.pubmed.ncbi.nlm.nih.gov
26. Guidelines for endoscopic treatment of postinflammatory pancreatic and peripancreatic fluid collections. Recommendations of the Endoscopic Surgery Section of the Association of Polish Surgeons, the Endoscopy Section of the Polish Society of Gastroenterology, the Polish Pancreatic Club, the Laparoscopic and Robotic Surgery Section of the Association of Polish Surgeons, and the Pancreatic Surgery Section of the Association of Polish Surgeons; formulated by an expert panel led by Prof. Mateusz Jagielski, MD, PhD.pubmed.ncbi.nlm.nih.gov
27. Differentiating walled-off pancreatic necrosis with no documented pancreatitis from mucinous cystic neoplasms: a multicenter LASSO-based nomogram.pubmed.ncbi.nlm.nih.gov
28. Endoscopic transgastric necrosectomy for infected necrotizing pancreatitis extending from the lesser Sac to the paracolic gutter in a pediatric patient: a case report.pubmed.ncbi.nlm.nih.gov
29. Experience in the Management of Peripancreatic Collections Using Endoscopic Ultrasound in a Tertiary Referral Hospital in Mexico.pubmed.ncbi.nlm.nih.gov
30. Clinical Profile and Management of Children with Pancreatic Fluid Collections: A Retrospective Observational Study.pubmed.ncbi.nlm.nih.gov
31. The role of imaging in acute pancreatitis.pubmed.ncbi.nlm.nih.gov
32. MR imaging for acute pancreatitis: the current status of clinical applications.pubmed.ncbi.nlm.nih.gov
33. Boerhaave Syndrome Caused by Pancreatitis-Induced Gastric Outlet Obstruction: A Case Report.pubmed.ncbi.nlm.nih.gov
34. A modified stent-free Chen's U-suture technique in pediatric pancreaticojejunostomy: safety and efficacy.pubmed.ncbi.nlm.nih.gov
35. Analysis of CT and MRI imaging features of ectopic pancreas.pubmed.ncbi.nlm.nih.gov
36. Postpancreatitis extrapancreatic necrosis mimicking peritoneal carcinomatosis: A pediatric diagnostic pitfall.pubmed.ncbi.nlm.nih.gov
37. The Relationship Between PANC-3 Score and Nutritional Risk Screening 2002 Score in Patients with Acute Pancreatitis.pubmed.ncbi.nlm.nih.gov
38. The diagnostic value of virtual unenhanced spectral CT images in acute pancreatitis: a comparison with true unenhanced images.pubmed.ncbi.nlm.nih.gov
39. Clinical, Radiological, and Endoscopic Features of Pancreatic Pseudocyst and Walled-Off Necrosis: How to Diagnose and How to Drain Them.pubmed.ncbi.nlm.nih.gov
40. Inguinoscrotal region as an unusual site of extra-pancreatic collections in infected pancreatic necrosis.pubmed.ncbi.nlm.nih.gov
41. An Unusual Case of Ascending Pancreatitis with Mediastinal Involvement: A Case Report with CT and MRI Findings.pubmed.ncbi.nlm.nih.gov
42. Imaging in scrub typhus - a pictorial review.pubmed.ncbi.nlm.nih.gov
43. Radiological Assessment After Pancreaticoduodenectomy for a Precision Approach to Managing Complications: A Narrative Review.pubmed.ncbi.nlm.nih.gov
44. Robot-assisted pancreatic necrosectomy for infected pancreatic necrosis secondary to severe acute pancreatitis: a single-center retrospective cohort study.pubmed.ncbi.nlm.nih.gov
45. Acute Necrotizing Pancreatitis With Infected Peripancreatic Collections and Upper Gastrointestinal Bleed Managed Via Multimodal Endoscopic Intervention.pubmed.ncbi.nlm.nih.gov
46. Case Report: Delayed complications of endovascular treatment of recurrent erosive hemorrhage in necrotizing pancreatitis.pubmed.ncbi.nlm.nih.gov
47. Normal saline versus lactated Ringer's solution for acute pancreatitis resuscitation, an open-label multicenter randomized controlled trial: the WATERLAND trial study protocol.pubmed.ncbi.nlm.nih.gov
48. Acute Necrotizing Pancreatitis Presenting With Extensive Unilateral Lower Limb Myositis, Fasciitis, and Sterile Reactive Knee Synovitis: A Rare Extra-pancreatic Manifestation.pubmed.ncbi.nlm.nih.gov
49. CT-derived visceral adiposity and paraspinal muscle depletion associated with severe acute pancreatitis according to the Revised Atlanta Classification.pubmed.ncbi.nlm.nih.gov
50. Diagnostic Performance of the Uric Acid-To-Albumin Ratio in Predicting Severity of Acute Pancreatitis.pubmed.ncbi.nlm.nih.gov
51. Clinical-radiological comparative evaluation of the BISAP and Computed tomography severity index scores as predictors of severity in acute pancreatitis.pubmed.ncbi.nlm.nih.gov
52. Rapid Interval Development of a Left Hepatic Artery Pseudoaneurysm During Acute Interstitial Edematous Pancreatitis.pubmed.ncbi.nlm.nih.gov
53. A Case of Acute Pancreatitis With Fat Saponification Mimicking Carcinomatosis in an Adolescent: Is It Carcinomatosis or Fat Necrosis?pubmed.ncbi.nlm.nih.gov
54. Subcapsular Pancreatic Pseudocyst of the Right Hepatic Lobe: A Rare Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
55. Isolated Blunt Pancreatic Head Injury with Evolving Acute Peripancreatic Fluid Collection in a Child Successfully Managed Conservatively.pubmed.ncbi.nlm.nih.gov
56. Nomogram for Predicting Pancreatic Pseudocyst in Hypertriglyceridemic Acute Pancreatitis: A Retrospective Cohort Study.pubmed.ncbi.nlm.nih.gov
57. Fluid Therapy in Acute Pancreatitis-Current Knowledge and Future Perspectives.pubmed.ncbi.nlm.nih.gov
58. Computed Tomography Findings in Intraabdominal Hypertension in Patients with Acute Pancreatitis.pubmed.ncbi.nlm.nih.gov
59. Pancreatic Endometriosis Coexisting with a Splenic Mesothelial Cyst: A Rare Case Report and Review of the Literature.pubmed.ncbi.nlm.nih.gov
60. A Study on the Spectrum of Imaging Findings of Post-ERCP-Specific Complications: A Retrospective Descriptive Study.pubmed.ncbi.nlm.nih.gov
61. Focal Autoimmune Pancreatitis Morphologically Mimicking Pancreatic Cancer: A Case Report and Literature Review.pubmed.ncbi.nlm.nih.gov
62. Percutaneous Interventions and Necrosectomy in the Management of Peripancreatic Collections.pubmed.ncbi.nlm.nih.gov
63. Laparoscopic distal pancreatectomy for pancreatic cancer: an overview of evaluation and treatment strategies.pubmed.ncbi.nlm.nih.gov
64. Stent-Assisted Percutaneous Direct Endoscopic Necrosectomy in Necrotizing Pancreatitis With Multidrug-Resistant Infection and Portal Vein Thrombosis.pubmed.ncbi.nlm.nih.gov
65. Pancreatic Pseudocyst Masquerading as Right Atrial Thrombus: An Unusual Intracardiac Extension.pubmed.ncbi.nlm.nih.gov
66. Ovarian cancer reporting lexicon for computed tomography (CT) and magnetic resonance (MR) imaging developed by the SAR Uterine and Ovarian Cancer Disease-Focused Panel and the ESUR Female Pelvic Imaging Working Group.pubmed.ncbi.nlm.nih.gov
67. Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.pubmed.ncbi.nlm.nih.gov
68. Gastrointestinal complications of cocaine use: a narrative literature review.pubmed.ncbi.nlm.nih.gov
69. Acute Necrotizing Pancreatitis Secondary to Adhesive Afferent Loop Syndrome Six Years After Total Gastrectomy With Roux-en-Y Reconstruction: A Case Report.pubmed.ncbi.nlm.nih.gov
70. Adult Hepatic Infarction for Internists: A Practical Diagnostic and Management Pathway to Avoid Misdiagnosis, Unnecessary Drainage, and Delayed Vascular Recognition.pubmed.ncbi.nlm.nih.gov
71. The Aberrant Passage: A Rare Spontaneous Pancreatic Pseudocyst-Portal Vein Fistula.pubmed.ncbi.nlm.nih.gov
72. Utility of Diffusion Weighted Magnetic Resonance Imaging in Early Detection and Staging of Acute Pancreatitis: Correlation with Revised Atlanta Classificationpubmed.ncbi.nlm.nih.gov
73. Comments and Illustrations of Ultrasound Findings in Extrapulmonary Tuberculosis Manifestations.pubmed.ncbi.nlm.nih.gov
74. Infarcts and ischemia in the abdomen: an imaging perspective with an emphasis on cross-sectional imaging findings.pubmed.ncbi.nlm.nih.gov
75. Necrotizing Pancreatitis With Concurrent Clostridioides difficile Infection.pubmed.ncbi.nlm.nih.gov
76. When seizure control comes at a cost: valproic acid-induced necrotising pancreatitis in a patient receiving antiepileptic polypharmacy.pubmed.ncbi.nlm.nih.gov
77. Clinical relevance of hyperamylasemia and pancreatitis-like imaging linked with accidental hypothermia.pubmed.ncbi.nlm.nih.gov
78. Single-session therapeutic plasma exchange as salvage therapy for pegaspargase-induced severe acute pancreatitis accompanied by multiple organ dysfunction in a pediatric patient with B-cell precursor acute lymphoblastic leukemia: a case report.pubmed.ncbi.nlm.nih.gov
79. Computed tomography of pediatric abdominal trauma: optimizing utilization and enhancing diagnostic interpretation.pubmed.ncbi.nlm.nih.gov
80. The Story Retold: The Kocher Manoeuvre.pubmed.ncbi.nlm.nih.gov
81. Apolipoprotein A-I: a non-negligible marker in hypertriglyceridemia-induced acute pancreatitis.pubmed.ncbi.nlm.nih.gov
82. Nodal metastasis from an occult duodenal gastrinoma amid an overlap of xanthogranulomatous and type 1 autoimmune pancreatitis: A case report.pubmed.ncbi.nlm.nih.gov
83. Beyond embryological remnants: imaging of ligamentum teres hepatis and falciform ligament pathologies.pubmed.ncbi.nlm.nih.gov
84. Insights into Acute Pancreatitis: Pathogenesis, Diagnosis, and Management.pubmed.ncbi.nlm.nih.gov
85. Navigating the labyrinth of peritoneal and extraperitoneal anatomy: abdominal spread made easy with a case based review.pubmed.ncbi.nlm.nih.gov
86. Radiological diagnosis of perinephric pathology: pictorial essay 2015.pubmed.ncbi.nlm.nih.gov
87. Retrocrural space involvement on computed tomography as a predictor of mortality and disease severity in acute pancreatitis.pubmed.ncbi.nlm.nih.gov

Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.