Complications of Acute Pancreatitis: How the Radiologist Can Help

Acute pancreatitis (AP) is a leading gastrointestinal cause of emergency department visits and hospitalization in the United States and has been increasing in incidence worldwide. One-third of patients with AP will develop moderately severe disease, which is characterized by local complications such as acute pancreatic and peripancreatic fluid collections, acute necrotic collections, pseudocysts, walledoff necrosis, arterial pseudoaneurysm, venous thrombosis, biliary obstruction, and bowel obstruction. These patients often require longer hospitalizations, multiple procedures, and complex management strategies that include input from pancreaticobiliary surgeons, advanced endoscopic gastroenterologists, interventional and diagnostic radiologists, infectious disease specialists, and nutritionists. This Pictorial Essay describes pancreatitis-related complications, including collections as defined by the revised Atlanta criteria; collection management strategies; and key elements that should be included in a radiology report before and after intervention that can help guide management.