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Clinical, Biochemical, and Radiologic Parameters at Admission Predicting Formation of a Pseudocyst in Acute Pancreatitis

Poornachandra, Kuchhangi Sureshchandra DM*; Bhasin, Deepak Kumar DM*; Nagi, Birinder MD*; Sinha, Saroj Kant DM*; Rana, Surinder Singh DM*; Shafiq, Nusrat DM; Greer, Katarina MD; Gupta, Rajesh MCh§; Kang, Mandeep MD; Malhotra, Samir DM; Singh, Kartar DM*

Journal of Clinical Gastroenterology: February 2011 - Volume 45 - Issue 2 - p 159–163
doi: 10.1097/MCG.0b013e3181dd9d14

Goals To evaluate clinical, biochemical, and radiologic parameters at admission, which predict the development of acute pseudocyst (AP) after acute pancreatitis.

Background There is limited data on factors that predict the development of AP.

Study Seventy-five consecutive patients with AP were prospectively enrolled and subjected to clinical, laboratory, and radiologic investigation. The patients were followed up for a period of 4 weeks and then investigated radiologically for the development of AP.

Results After exclusion, 65 patients (44 males) were studied. The median age was 37 years (40.9±15.5 y). Etiology of acute pancreatitis was alcohol in 24 patients, gallstones in 18, both in 4, drugs in 4, pancreas divisum in 2, postendoscopic retrograde cholangiopancreatography in 1, trauma in 1, and idiopathic in 11 patients. On admission, acute fluid collections were observed in 34 (52.31%) patients. Necrosis was noted in 38 (58.46%) patients (<30% necrosis, 30% to 50% necrosis, and >50% necrosis was observed in 36.8%, 26.3%, and 36.8% patients, respectively). On follow-up, 34 (52.3%) patients developed a pseudocyst. On univariate analysis, the factors significantly associated with pseudocyst formation were male sex, palpable mass, blood sugar greater than 150 mg/dL, necrosis, sepsis, acute fluid collections, presence of ascites, pleural effusion, a high grade of pancreatitis, and a high computed tomography severity index (CTSI) score. Multivariate regression analysis showed that male sex, presence of a palpable abdominal mass, ascites, and a high CTSI score were associated with the development of AP.

Conclusions Male sex, palpable mass, ascites, and a high CTSI score at admission can predict the development of a pseudocyst after an attack of acute pancreatitis. Acute pancreatitis patients with these parameters at admission should be closely followed for the development of a pseudocyst.

Departments of *Gastroenterology

Clinical Pharmacology


Radiodiagnosis, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

Division of Gastroenterology, University Hospitals Case Medical Center, Cleveland, OH

No conflicts of interest and no financial disclosures to be made.

Study performed with ethical adherence.

Reprints: Deepak Kumar Bhasin, DM, 1041, Sector 24-B, Chandigarh—160 023, India (e-mail:;

Received January 15, 2010

Accepted March 12, 2010

© 2011 Lippincott Williams & Wilkins, Inc.