Acute peripancreatic fluid collection

Last revised by Dr Jeremy Jones on 20 Sep 2021

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 edematous pancreatitis, not in necrotizing pancreatitis

The following are the latest terms according to the updated Atlanta classification to describe fluid collections associated with acute pancreatitis 1,2:

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

Most acute peripancreatic fluid collections resolve spontaneously with conservative management in the first few weeks. They very rarely become infected. Drainage (surgical/percutaneous) is not recommended 1,2.

  • acute necrotic collection (ANC): radiographic differentiation between it and an acute peripancreatic fluid collection in the first week may prove impossible 1
  • pancreatic necrosis: fluid collections can accumulate within the pancreas (acute peripancreatic fluid collection are always peripancreatic, as their name implies) 1

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Cases and figures

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