Acute peripancreatic fluid collection
Citation, DOI and article data
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:
- fluid collections in interstitial edematous pancreatitis
- fluid collections in necrotizing 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 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
- 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
- 4. Goyal J, Ramesh J. Endoscopic management of peripancreatic fluid collections. (2015) Frontline gastroenterology. 6 (3): 199-207. doi:10.1136/flgastro-2014-100444 - Pubmed