Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography

Silverstein, William K.; Isikoff, Michael B.; Hill, Michael C.; Barkin, Jamie S.

doi:10.2214/ajr.137.3.497

Cited by 130 publications

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“…26 In another study by William Silverstein et al pancreatic visualization was found in 62% of cases which was also similar to present study While chronic pancreatitis calcification and visualization of pancreas was found in 100% of casts, Followed by pancreatic enlargement in 50% of cases and pseudocyst in 20% of cases. 27 These findings are almost similar to those by Ferrueci JT who had pancreatic calcification in 66% and pseudocyst in 25% of cases. 28 So, ultrasonography was helpful in the diagnosis of chronic pancreatitis in 100% of cases.…”

supporting

confidence: 87%

“…These findings were quite similar to those in the study by Silverstain W et al who showed abnormal pancreatic (visualization of pancreas) imaging in 98% of cases and pseudocyst in 10% of cases. 27 Another study by Janet T. Husband et al showed pancreatic visualization in 87.5% of the cases. 26 According to CT scan severity index, pancreatic enlargement and peri pancreatic fat involvement (grade 1 -2) was found in 72.5% of the cases, peri pancreatic fluid collection in 25% of cases, normal pancreas in 2.5% of cases and in pancreatic necrosis 25% of the cases in present study.…”

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confidence: 95%

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A prospective study of clinical, biochemical and radiological features in pancreatitis

et al. 2017

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Background: Pancreatitis is quite common problem, it may present either as abdominal emergency with fulminant course or as an indolent process leading to long-term medical as well as surgical complications often leading to poor prognosis if not intervened timely.Methods: The present study conducted in the department of medicine, Dr. S. N. medical college, Jodhpur. Participants after understanding the study protocol and procedure, asked to give their written consent for the study. A cross sectional hospital based study in patients admitted in various medical wards of Dr. S. N. medical college, Jodhpur. 50 patients with acute and chronic pancreatitis were studied.Results: In the present study, most common cause of acute pancreatitis is biliary disease (50%) followed by alcoholism (37.5%) and in chronic pancreatitis is alcoholism (80%). Acute pancreatitis was more common in males (62.5%, 25 males) whereas chronic pancreatitis in males (80%, 8 male). Abdominal pain is the most common symptom (97.5%) followed by nausea-vomiting (92.5%) in acute pancreatitis. The history of previous abdominal pain in 100% of cases followed by epigastria pain in 90% of cases, in chronic pancreatitis. The amylase and lipase were elevated in 90% of cases. The amylase and lipase levels did not correlate with the severity. 66.6% of patients had severe pancreatitis with a positive predictive value of 66.6%. The ultrasonography imaging of pancreas was helpful in 70% and 100% in acute and chronic pancreatitis respectively. The CT scan was a better imaging modality as compared to ultrasonography in acute pancreatitis, where as it scored over ultrasonography imaging in chronic pancreatitis with complications.Conclusions: Relevant clinical history, ultrasonography and computed tomography scan of pancreas are helpful in diagnosis of pancreatitis. The computed tomography scan was a better imaging modality as compared to ultrasonography.

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confidence: 87%

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confidence: 95%

A prospective study of clinical, biochemical and radiological features in pancreatitis

et al. 2017

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“…Alcohol was the main aetiology in present study due to the high prevalence of alcohol consumption in the area where the present study was conducted .In study by Silverstein et al 8 , the most common aetiology of acute pancreatitis was alcohol (57 patients) followed by trauma (17 patients). In the present study, alcohol was the most common aetiology followed by idiopathic and trauma.…”

Section: Prognostic Criteria Used For Evaluation Modified Ct Severitymentioning

confidence: 69%

Acute Pancreatitis and Its Complications: MDCT Versus Usg: An Overview

Gonegandla¹,

Ayesha²,

G³

et al. 2016

jemds

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OBJECTIVEImaging plays a central role in the management of selected cases of acute pancreatitis and its complications, complementing laboratory investigations such as serum amylase and lipase levels that have relatively high sensitivity and specificity. In addition to clinical signs and laboratory investigations, imaging helps in confirming the clinical diagnosis when there is uncertainty and elucidates the cause and grade the extent and severity of acute pancreatitis. It also aids in the early detection of complications. MATERIAL AND METHODSUltrasound and CECT Abdomen were done in 55 patients with a typical clinical suspicion of acute pancreatitis. The findings were correlated with biochemical parameters and the discrepancy between the two modalities i.e. USG and CT was evaluated. RESULTSAbout 55 cases were studied and they were subjected to USG and CT (plain and contrast). Most of the patients were males with male to female ratio 13:1. Most common aetiology was chronic alcohol consumption (42 cases, 76.33%) followed by idiopathic (11 cases, 20%) and trauma (2 cases, 3.66%). Multiple sites of involvement (35 cases, 63.65%) was more common than focal involvement of pancreas. Severe form of pancreatitis (37 cases, 67.27%) was the most common type according to MCTSI. The most common complication was ascites (cases, 56.36%) and pleural effusion (16 cases, 29.09%). CONCLUSIONThe sensitivity of USG in detecting acute pancreatitis was 41.8%. The sensitivity of CT (plain and contrast) in detecting pancreatitis was 100%. Modified CT severity index shows significant correlation between severity of pancreatitis and patient outcome. Serum lipase is more accurate in detecting acute pancreatitis than serum amylase. Thus, from the present study, it can be concluded that CT (plain and contrast) is superior in detecting and evaluating pancreatitis. Hence, CT plain and contrast should be performed in all cases of clinically suspected pancreatitis especially with positive serological findings.

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“…Unfortunately it is more costly than ultrasound, involves radiation exposure, and requires intravenous contrast medium. 25 Findings of acute pancreatitis frequently seen on CT include diffuse or segmental enlargement of the gland, irregular pancreatic contour, obliteration of peripancreatic fat planes, parenchymal heterogeneity, and ill-defined fluid collections within the pancreas or in the lesser sac and pararenal spaces. 26 CT scan may also be used to detect pancreatic necrosis, an important finding for the management and prognosis of this disease.…”

Section: Choosing the Appropriate Imaging Modalitymentioning

confidence: 99%

“…27 Despite this, normal CT findings have been reported in patients with acute pancreatitis, and certain CT findings may be related to disease severity. 25 Although MRI is less commonly used in the diagnosis of acute pancreatitis, it may provide a useful alternative to CT, especially in cases of renal failure or intravenous contrast hypersensitivity. When combined with magnetic resonance cholangiopancreatography (MRCP) imaging, MRI may even be able to detect a local area of pancreatic duct disruption.…”

Section: Choosing the Appropriate Imaging Modalitymentioning

confidence: 99%

Acute pancreatitis

Munsell

Buscaglia

2010

Journal of Hospital Medicine

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Acute pancreatitis is a common disease most frequently caused by gallstone disease or excess alcohol ingestion. Diagnosis is usually based on characteristic symptoms, often in conjunction with elevated serum pancreatic enzymes. Imaging is not always necessary, but may be performed for many reasons, such as to confirm a diagnosis of pancreatitis, rule out other causes of abdominal pain, elucidate the cause of pancreatitis, or to evaluate for complications such as necrosis or pseudocysts. Though the majority of patients will have mild, self‐limiting disease, some will develop severe disease associated with organ failure. These patients are at risk to develop complications from ongoing pancreatic inflammation such as pancreatic necrosis, fluid collections, pseudocysts, and pancreatic duct disruption. Validated scoring systems can help predict the severity of pancreatitis, and thus, guide monitoring and intervention.Treatment of acute pancreatitis involves supportive care with fluid replacement, pain control, and controlled initiation of regular food intake. Prophylactic antibiotics are not recommended in acute pancreatitis if there is no evidence of pancreatic infection. In patients who fail to improve, further evaluation is necessary to assess for complications that require intervention such as pseudocysts or pancreatic necrosis. Endoscopy, including ERCP and EUS, and/or cholecystectomy may be indicated in the appropriate clinical setting. Ultimately, the management of the patient with severe acute pancreatitis will require a multidisciplinary approach. Journal of Hospital Medicine 2010;5:241–250. © 2010 Society of Hospital Medicine.

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Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography

Cited by 130 publications

References 15 publications

A prospective study of clinical, biochemical and radiological features in pancreatitis

A prospective study of clinical, biochemical and radiological features in pancreatitis

Acute Pancreatitis and Its Complications: MDCT Versus Usg: An Overview

Acute pancreatitis

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