Prospective study of 310 patients: can early CT predict the severity of acute pancreatitis?

Knoepfli, A.-S.; Kinkel, Karen; Berney, Thierry; Morel, Philippe; Becker, Christoph; Poletti, Pierre–Alexandre

doi:10.1007/s00261-006-9034-y

Cited by 31 publications

(20 citation statements)

References 27 publications

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“…An extrapancreatic finding can be assessed on the basis of the CT scan (cholecystolithiasis, choledocholithiasis, vein thrombosis and ascites) or other abnormalities in the abdominal cavity. MRI provides very similar results [14][15][16][17] .…”

Section: Classification Of Acute Pancreatitis With the Use Of Imagingsupporting

confidence: 73%

Role of Imaging Methods in Diagnosis of Acute Pancreatitis

Válek

Kala²,

Dítě³

2010

Dig Dis

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Diagnosis and treatment of acute pancreatitis is a complex interdisciplinary team problem. Without knowledge of classification and the current opinion of other experts on this disease, the radiologist cannot be an adequate partner in this team. Nonetheless, the radiologist has a very important position, primarily ‘thanks to’ computed tomography (CT) in diagnosis and fading of the disease and the possibilities offered by minimally invasive treatment of early and late complications of this disease. A turning point from the viewpoint of diagnosing acute pancreatitis was first marked by Balthazar’s classification and then establishing the CTSI (severity index for the disease based on CT findings), proposed by Balthazar as well. Radiologists’ increasingly more active approach to drainage of acute fluid collections and pseudocysts in patients with acute pancreatitis as well as some possibilities for percutaneous treatment of necroses has led to a reassessment of surgeons’ attitudes. A persistent problem is the correct indication and timing of CT scans and the drainage itself. In their concise communication, the authors present data from the literature and summarize their own experience. They highlight the most common mistakes, especially in the indication and timing of individual methods. Finally, they present their views on a practical approach to the use of CT and percutaneous drainage in these patients.

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Section: Classification Of Acute Pancreatitis With the Use Of Imagingsupporting

confidence: 73%

Role of Imaging Methods in Diagnosis of Acute Pancreatitis

Válek

Kala²,

Dítě³

2010

Dig Dis

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“…However, MCTSI was more closely associated with patient outcome than CTSI in our study. Several studies reported a strong correlation between the CT evaluation and the clinical severity of acute pancreatitis [14,20,21] and some studies have not corroborated these findings [22][23][24].…”

Section: Correlation Of Ct Scoring Indexes With Patient Outcome Parammentioning

confidence: 99%

Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study

Banday

Gattoo

Khan

et al. 2015

JCDR

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IntrOductIOnAcute Pancreatitis is a common condition presenting as acute abdomen. This condition is broadly classified into two subtypes: one, oedematous or mild acute pancreatitis and two, a necrotizing or severe acute pancreatitis. The majority of patients have mild interstitial edematous pancreatitis (IOP) which is self-limiting. However 20% have severe acute pancreatitis (SAP) which can progress to a systemic inflammatory response syndrome (SIRS) and result in septic systemic complications with significant morbidity and mortality [1].The most common causes of pancreatitis are choledocholithiasis and ethanol abuse. Other causes include trauma, metabolic disorders (hyperlipidemia, hypercalcemia), ERCP induced pancreatitis, medications (azathioprine, sulphonamides), tumours, and congenital anomalies such as pancreas divisum [2]. Aim:To study role of modified computed tomography severity index in evaluation of acute pancreatitis and its correlation with clinical outcome. Materials and Methods:This was a hospital based prospective correlative study done on patients of all age groups referred to the Department of Radio diagnosis from the various indoor and outdoor departments of the hospital, with clinical/Laboratory/ ultrasonography findings suggestive of acute pancreatitis. The severity of pancreatitis was scored using Modified CT severity index & CT severity index and classified into mild, moderate and severe categories. Total of 50 patients of acute pancreatitis presenting to the emergency department of our hospital were included in the study. Clinical outcome parameters for correlation collected from respective referral departments included, the length of hospital stay (in days), need for surgical intervention, need for percutaneous intervention (aspiration and drainage), evidence of infection in any organ system (combination of a fever > 100°F and elevated WBC >15,000/ mm³), evidence of organ failure (PaO 2 < 60 mm Hg or need of ventilation, systolic BP of < 90 mm Hg,

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“…a bowel perforation. However, there is no consensus whether to perform a CT in the early course of AP as a prognostic indicator [4,9,11,14,15,16,17,18,19,20,21,22,23]. Scientific proof that development of pancreatic necrosis occurs as early as within 96 h after symptom onset is disputable [15].…”

Section: Introductionmentioning

confidence: 99%