Acute peripancreatic fluid collections (APFC) are an early complication of acute pancreatitis that usually develop in the first four weeks. After four weeks, the term pseudocysts is used. The absence of necrosis differentiates APFCs from acute necrotic collections (ANC), that is, APFCs occur in interstitial oedematous pancreatitis not in necrotising pancreatitis.
The following are the latest terms according to the updated Atlanta classification to describe fluid collections associated with acute pancreatitis 1,2:
- fluid collections in interstitial oedematous pancreatitis
- fluid collections in necrotising pancreatitis
APFCs result from pancreatic/peripancreatic inflammation and/or rupture of one of the small pancreatic side ducts 1.
Homogeneous peripancreatic fluid collection, that is non-encapsulated and bound by the retroperitoneum 1,2.
Treatment and prognosis
Most APFCs resolve spontaneously in the first few weeks. They very rarely become infected. Drainage (surgical/percutaneous) is not recommended 1,2.
- acute necrotic collection (ANC): may not be able delineate between APFCs and ANCs in the first week 1
- pancreatic necrosis: fluid collections within the pancreas (APFCs are always peripancreatic) 1
- cystic neoplasm (cystic pancreatic mass differential diagnosis)
- solid neoplasm
- nonepithelial pancreatic neoplasms
- gallstone pancreatitis
- interstitial oedematous pancreatitis
- necrotising pancreatitis
- haemorrhagic pancreatitis
- revised Atlanta classification of acute pancreatitis
- chronic pancreatitis
- Ascaris-induced pancreatitis
- tropical pancreatitis
- autoimmune pancreatitis
- emphysematous pancreatitis
- hereditary pancreatitis
- pancreatitis associated with cystic fibrosis
- segmental pancreatitis
- acute pancreatitis
- pancreatic atrophy
- pancreatic lipomatosis
- pancreatic trauma
- 1. Thoeni RF. The revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment. Radiology. 2012;262 (3): 751-64. doi:10.1148/radiol.11110947 - Pubmed citation
- 2. Banks PA, Bollen TL, Dervenis C et-al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2012;62 (1): 102-11. doi:10.1136/gutjnl-2012-302779 - Pubmed citation
- 3. Murphy KP, O'Connor OJ, Maher MM. Updated imaging nomenclature for acute pancreatitis. AJR Am J Roentgenol. 2014;203 (5): W464-9. doi:10.2214/AJR.13.12222 - Pubmed citation