Comparison of the imaging and clinical characteristics between Initial and Recurrent Alcoholic Acute Pancreatitis: a retrospective cross-sectional study

ABSTRACT

Background: Patients with a first episode of Alcoholic Acute Pancreatitis (AAP) may experience Recurrent Alcoholic Acute Pancreatitis (RAAP). However, few reports have focused on RAAP imaging characteristics.

Objectives: The aim of this study was to compare the imaging and clinical characteristics between Initial Alcoholic Acute Pancreatitis (IAAP) and RAAP.

Materials

Patients with alcoholic acute pancreatitis in our hospital were recruited from Jan 2019 to July 2022 and divided into IAAP and RAAP groups. All patients underwent Contrast-Enhanced Computerized Tomography (CECT) or Magnetic Resonance Imaging (MRI) after administration. Imaging manifestations, local complications, severity scores on the Modified CT/MR Severity Index (MCTSI/MMRSI), Extrapancreatic Inflammation on CT/MR (EPIC/M), clinical severity [Bedside Index for Severity in Acute Pancreatitis (BISAP) Acute Physiology and Chronic Health Evaluation (APACHE-II)], and clinical prognosis were compared between the two groups.

Results: 166 patients were recruited for this study, including 134 IAAP (male sex 94%) and 32 RAAP patients (male sex 100%). On CECT or MRI, IAAP patients were more likely to develop ascites and Acute Necrosis collection (ANC) than RAAP patients (ascites:87.3%vs56.2%; P = .01; ANC:38%vs18.7%; P < .05). MCTSI/MMRSI and EPIC/M scores were higher in IAAP than in RAAP patients(MCTSI/MMRSI:6.2vs5.2; P < .05; EPIC/M:5.4vs3.8; P < .05).Clinical severity scores (APACHE-II and BISAP), length of stay, and systemic complications [Systemic Inflammatory Response Syndrome (SIRS), respiratory failure] were higher in the IAAP group than in the RAAP group (P < .05). No mortality outcomes were reported in either group while hospitalized.

Conclusions: Patients with IAAP had more severe disease than those with RAAP. These results may be helpful for differentiating care paths for IAAP and RAAP, which are essential for management and timely treatment in clinical practice.

KEYWORDS:

• Acute pancreatitis
• recurrent acute pancreatitis
• alcohol
• CECT
• MR

Authors’ contributions

XMZ, XHL and WHX proposed the study. WHX, XHL, LJY, ZT, CC, CL and HZL performed research, and collected the data. WHX and XMZ analyzed the data and wrote the first draft. All authors contributed to the interpretation of the study and to further drafts. All authors read and approved the final manuscript. XMZ is the guarantor. WHX and XHL contribute equally to this work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Consent for publication

All authors gave consent for the publication of this paper.

Ethics approval and consent to participate

This retrospective study was approved by the institutional review board of the Affiliated Hospital of North Sichuan Medical College. Due to a retrospective study, the patient consent for the study was waived.

Data availability statement

Please contact the corresponding author for data requests.

Additional information

Funding

This work was supported by the (National Natural Science Foundation of China) under Grant (81871440).