Acute pancreatitis, its diagnosis with special reference to contrast enhanced CT scan (CECT) and serum enzyme studies: a comparative study in tertiary referral hospital of Odisha, India

Abstract

Background: Acute pancreatitis is sudden swelling and inflammation of the pancreas. It can be diagnosed on the basis of clinical and laboratory data. At times, it may be difficult to differentiate it from other acute abdominal conditions. In these patients, serum enzymes (amylase and lipase) study, imaging by ultrasonography (USG) and/or computed tomography (CT) is of immense value in arriving at a diagnosis. In this study, we have compared the role of serum enzymes (amylase and lipase) levels, with the imaging studies (US/CECT scan) in relation to early diagnosis of acute pancreatitis and to find out the most specific and sensitive diagnostic modality.Methods: 300 patients (220 males, 80 females) in age group of 21 to 62 years with a clinical diagnosis of acute pancreatitis, which were admitted to surgical ward of S.C.B. Medical College Hospital, Cuttack during a period from November 2013 to October 2015, were included in the study. All selected cases (clinically diagnosed as acute pancreatitis) were serially subjected to tests of serum amylase and lipase estimation, USG and CECT scan of abdomen.Results: In our study the most common cause found was gall stone disease followed by chronic alcoholism. Serum amylase test showed diagnostic accuracy of 46.66% whereas serum lipase it was 70 %. Further USG of abdomen diagnostic accuracy was 83.33%, finally CECT scan had a diagnostic accuracy of 93.33%.Conclusions: Comparing all the diagnostic modalities described above it was found that contrast enhanced CT scan has highest accuracy rate (i.e. about 93% in our study) in detecting acute pancreatitis. This study proved that CECT scan was very important in the following up of the patients in order to detecting regression of disease appearance and complication in relation to acute pancreatitis.

A Comparative Study Between Apache Ii and Ranson’s Scoring Systems in Predicting the Severity of Acute Pancreatitis

“…The mean age of studied cases was found to be s 43.45 years (median 41 years). Similar male preponderance was also reported by the authors such as Panda et al [12] and Satoh et al [13].…”

Adherence to the evidence-based guidelines in the management of acute biliary pancreatitis: A case series

“…In other studies such as Bhatt et al, 2017 and Panda et al, 2017 , Lalith and Ilangovan, 2019, US signs of AP were detected in 52%, 80%, and 88% of cases respectively. The wide variation in results can be explained by the obscured vision of the pancreas by the overlying bowel gas and the operator’s expertise and on the refinement of the equipment [ [22] , [23] , [24] ]. Regarding CT use for diagnosis in this study, it was done in 8/25 cases (32%) presented in the early phase of AP.…”

Comparison of ultrasound and Contrast- enhanced computed tomography in clinically diagnosed cases of acute pancreatitis

“…[2][3][4] The mortality in severe AP can be as high as 30% 5 , however, the overall mortality in AP is estimated at 5%. 6 Gallstones remain the most common cause for AP 7 ; while, up to 25% of cases can be attributed to alcohol 8 and 20-34% idiopathic. The incidence of idiopathic cases is similar in both men and women.…”