Diagnosis and Staging of Acute Pancreatitis on Multidetector Computed Tomography
International Journal of Chinese Medicine
Volume 3, Issue 3, September 2019, Pages: 41-47
Received: Jul. 5, 2019; Accepted: Aug. 7, 2019; Published: Aug. 28, 2019
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Sameera Vakil, Department of Radiology, Dow University of Health Sciences, Karachi, Pakistan
Hina Siddiqui, Department of Radiology, Dow University of Health Sciences, Karachi, Pakistan
Maria Hassan, Department of Radiology, Dr Ziauddin Hospital, Karachi, Pakistan
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INTRODUCTION: Acute pancreatitis is a protean disease with varying clinical findings from mild to severe. CT is the imaging modality of choice to help stage the severity of inflammatory processes, detect pancreatic necrosis and depict local complications. Objectives of this study was to evaluate the role of MDCT in diagnosis and staging of acute pancreatitis and to identify the complications of acute pancreatitis on CT scanning. MATERIAL AND METHODS: This was a descriptive study done from 26th September 2016 to 25th March 2017. 45 patients of age range 17-85 years (29 Male and 16 Female) were included in study. CT scans were assessed for pancreatic necrosis and its complications. Computed tomography severity index (CTSI) was calculated by Balthazar’s grading + degree of necrosis points into mild, moderate and severe CTSI. RESULTS: 14 patients had mild, 14 had moderate and 17 patients had severe acute pancreatitis CTSI. Of 31 patients with pancreatic necrosis 26 (83.8%) patients showed complications and 5 (16.12%) patients were without complications. Of 14 patients without pancreatic necrosis only 5 (35.7%) patients were with complications and 9 (64%) were without complications. CONCLUSION: CT scan should be the investigation of choice if clinical diagnosis is acute pancreatitis and to assess the severity of disease to predict its course.
Acute Pancreatitis, Multidetector Computed Tomography, Computed Tomography Severity Index (CTSI)
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Sameera Vakil, Hina Siddiqui, Maria Hassan, Diagnosis and Staging of Acute Pancreatitis on Multidetector Computed Tomography, International Journal of Chinese Medicine. Vol. 3, No. 3, 2019, pp. 41-47. doi: 10.11648/j.ijcm.20190303.12
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Bader HA, Abd El Azeem AS. Role of computed tomography in diagnosis, follow-up, and minimally invasive treatment of acute pancreatitis. Sci J Al-Azhar Med Fac Girls 2018; 2: 52-7.
Lim YY, O’Shea S, Lee SH. Diagnostic and interventional radiology workload in acute pancreatitis in an ITU/HDU setting. Clinical Radiology 2006; 61: 86-90.
Jiruppabha B. CT appearance of acute pancreatitis using multiphase Multidetector Computed Tomography and correlation between CT Severity Index and clinical outcomes. Chula Med J Vol. 63 No. 3 July - September 2019; 153-161.
Balthazar EJ. Complications of acute pancreatitis: clinical and CT evaluation. Radiol Clin North Am 2002; 40: 1211-1227.
Chishty IA, Bari V, PashaS, BurhanD, HaiderZ, Rafique Z. Role of computed tomography in acute pancreatitis and its complications among age groups. J Pak Med Assoc 2005; 10: 431-435.
Balthazar EJ. Staging of acute pancreatitis. Radiol Clin North Am 2002; 40: 1199-1209.
Aschoff AJ, Gessel RV, BrambsHJ, Merkle EM. Effect of iodine concentration of contrast media on contrast enhancement in multislice CT of the pancreas. British Journal of Radiology 2004; 77: 821-830.
Johnson CD. Pancreatic carcinoma: developing a protocol for multidetector row CT. Radiology 2001; 220: 3-4.
Mortele KJ, Mergo PJ, Taylor HM, Ernst MD, Ros PR. Renal and perirenal space involvement in acute pancreatitis: Spiral CT findings. Abdominal Imaging 2000; 25: 272-8.
Mortele KJ, Mergo PJ, Taylor HM, Ernst MD, Ros PR. Splenic and perisplenic involvement in acute pancreatitis: Determination of prevalence and morphologic helical CT features. J Computer Assisted Tomography 2001; 25: 50-4.
Tsushima Y, Tamura T, Tomioka K, Okada C, Kusano S, Endo K. Transient splenomegaly in acute pancreatitis. BJR 1999; 72: 637-43.
Russo MW, Wei JT, Thiny MT, Gangarosa LM, Brown A, Ringel Y, et al. Digestive and liver diseases statistics, 2004. Gastroenterology 2004; 126: 1448-53.
Triester SL, Kowdley KV. Prognostic factors in acute pancreatitis. J Clin Gastroenterol 2002; 34: 167-76.
Dervenis C, Johnson CD, Bassi C, Bradley E, Imrie CW, McMahon MJ, et al. Diagnosis, objective assessment of severity, and management of acute pancreatitis. Santorini consensus conference. Int J Pancreatol 1999; 25: 195-210.
Gürleyik G, Emir S, Kiliçoglu G, Arman A, Saglam A. CTSI, APACHE II score and serum CRP concentration for predicting the severity of acute pancreatitis. JOP 2005 Nov 10; 6 (6): 562-7.
Society for Surgery of the Alimentary Tract (SSAT). Treatment of acute pancreatitis. Manchester, Mass.: Society for Surgery of the Alimentary Tract (SSAT), 2004. Accessed December 8, 2006, athttp//www.guidelines.gov/summary/summary.aspx?view_id=1&doc_id=5512#s25.
Mitchell RM, Byrne MF, Baillie J. Pancreatitis. Lancet 2003; 361: 1447-55.
Smotkin J, Tenner S. Laboratory diagnostic tests in acute pancreatitis. J Clin Gastroenterol 2002; 34: 459-62.
Frossard JL, Hadengue A, Pastor CM. New serum markers for the detection of severe acute pancreatitis in humans. Am J Respir Crit Care Med 2001; 164: 162-70.
Neoptolemos JP, Kemppainen EA, Mayer JM, Fitzpatrick JM, Raraty MG, Slavin J, et al. Early prediction of severity in acute pancreatitis by urinary trypsinogen activation peptide: a multicentre study. Lancet 2000; 355: 1955-60.
Tenner S. Initial management of acute pancreatitis: critical issues during the first 72 hours. Am J Gastroenterol 2004; 99: 2489-94.
Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology 1990; 174: 331-6.
Robert JH, Frossard JL, Mermillod B, Soravia C, Mensi N, Roth M, et al. Early prediction of acute pancreatitis: prospective study comparing computed tomography scans, Ranson, Glasgow, acute physiology and chronic health evaluation II scores and various serum markers. World J Surg 2002; 26: 612-9.
Simchuk EJ, Traveso LW, Nukui Y, Kozarek RA. Computed tomography severity index is a predictor of outcomes for severe pancreatitis. Am J Surg 2000; 179: 352-5.
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