CT guided percutaneous fine needle aspiration for early diagnosis of pancreatic infection after acute necrotizing pancreatitis

OBJECTIVE: To assess CT-guided percutaneous fine needle aspiration (FNA) for early diagnosis of pancreatic infection after acute necrotizing pancreatitis. METHODS: CT-guided percutaneous FNA was employed to diagnose pancreatic infection after acute necrotizing pancreatitis in 14 patients. The aspirates were smeared, cultured and subjected polymerase to chain reaction (PCR) for detecting bacteria. RESULTS: Ten patients were diagnosed as having pancreatic infection and 4 non-pancreatic infection. FNA was totally performed for 15 times: left retroperitoneal route for 12 times, left and right retroperitoneal route for one time, and transperitoneal route for two times. The sensitivity of smear, PCR, culture to diagnose pancreatic infection was 7/10, 9/10, 10/10, respectively. Their specificity was 4/4, and the time for obtaining the results was 30 minutes, 4 hours, 3 days respectively. CONCLUSIONS: Retroperitoneal approach can be used for most patients with acute necrotizing pancreatitis when performing CT guided-percutaneous FNA. PCR of aspirates is a rapid and accurate method to diagnose pancreatic infection.