Identification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging.
Open accessAbstract
One hundred and five of 395 patients with acute pancreatitis were surgically treated in our clinic from 1981 to 1984. Ninety three of these patients were examined with contrast enhanced computed tomography and/or ultrasound and were clinically assessed according to Ranson's objective criteria before operation. At operation, 77 patients showed necrotising pancreatitis and 16 showed biliary acute interstitial pancreatitis. Ninety per cent of the cases with extensive and 79% of those with minor necroses of the pancreas had been demonstrated with contrast enhanced computed tomography. Ultrasound failed to be diagnostic in 24% of the patients due to meteorism; the sensitivity of the diagnostic studies for pancreatic necrosis was 73% regardless of the extent of the process. Using the early objective signs, seven patients with acute interstitial pancreatitis were classified as having a severe attack, whereas 30 patients with necrotising pancreatitis were categorised as mild attacks. We conclude that the contrast enhanced computed tomography is an aid in deciding on conservative or surgical treatment in a case of acute pancreatitis. Ultrasound does not appear to be an adequate method for determining pancreatic necrosis. The early objective signs fail to sufficiently identify the necrotising form of acute pancreatitis.
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Proteases have been shown to affect the efferocytosis effect of TAMs.
“These proteases have been shown to affect the efferocytosis effect of TAMs.”
From Macrophage efferocytosis mediated by the TP63-RAC2 pathway promotes immunosuppressive remodeling in esophageal cancer (2026) · cites this paper as [17]
The contrast-enhanced computed tomography results and Discussion assess imaging and clinical staging of pancreatic necrosis. Searches for proteases, efferocytosis, TAMs, and macrophage clearance found no passage in our copy addressing whether proteases affect TAM efferocytosis. The cited paper therefore does not verify the attributed claim. (LLM, conf=0.76)
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Research works printed but not linked: 24
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Xi, Y., Zhao, Z., Zhou, Y., Yin, C., Li, Y., Xu, X., Jin, W., Lin, C., Zhao, K., Kuang, J., et al. (2026) · Cell Reports Medicine · doi:10.1016/j.xcrm.2025.102529 · Cited by 12 · see citing works
“17 On the other hand, in the second differentiation trajectory, the C1 FN1 + macrophage subtype displayed predominant enrichment in immune-related pathways, including ‘‘leukocyte,’’ ‘‘immune,’’ and ‘‘lymphocyte’’ pathways.”
- Authors
- Block, S., Maier, W., Bittner, R., Büchler, M., Malfertheiner, P., & Beger, H. G.
- Affiliations
- Universität Ulm (DE)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1986-09
- Volume
- 27
- Issue
- 9
- Pages
- 1035-1042
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1433814
- OpenAlex
- W2101662208
- Cited by
- 173
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 4 · 2013: 2 · 2012: 2
- FWCI
- 17.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Keywords
- acute pancreatitis, pancreatic necrosis, contrast-enhanced CT, ultrasound, Ranson's criteria, clinical staging, diagnostic sensitivity, surgical treatment decision, conservative treatment
- MeSH terms
- Acute Disease, Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Necrosis, Pancreas, Pancreatitis, Prospective Studies, Tomography, X-Ray Computed, Ultrasonography
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