The Pleuropulmonary Manifestations of Pancreatitis

¹ Departments of Surgery of the Baltimore City Hospitals, and The Johns Hopkins University School of Medicine

One hundred and fifty-five cases of clinically proved pancreatitis were reviewed in order to determine the incidence of concurrent acute chest roentgenologic changes. The criteria for inclusion in this series necessitated that all patients have the established diagnosis of pancreatitis, supported by one or more elevated serum amylase determinations. All patients under consideration had normal chest x-ray films, either at the onset of their illness or at a prior examination. None had a history of physical or roentgenologic findings of chronic pulmonary disease. No chest lesion was considered significant if an operative procedure had been performed prior to the demonstration of the roentgen change. Any patient with a positive chest x-ray film whose sputum culture grew out pathogens was eliminated.

Twenty-two patients (14.2 per cent) were noted to have x-ray findings of pleural effusion, pleural reaction, plate-like atelectasis, or basilar infiltrates. Nine of these reactions were in the left chest, nine in the right, and three bilateral.

One hundred cases of acute cholecystitis were also reviewed, and a 6 per cent incidence of minimal, transient chest roentgenologic changes were noted.

Familiarity with the significance of these roentgenologic changes in acute pancreatitis will help establish the early recognition of this potentially lethal disease.