Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index
Introduction: Acute pancreatitis is a disease with high rate of morbidity and mortality and is known to run an unpredictable course. CT is the standard non invasive investigation to evaluate pancreatic parenchymal changes, peri pancreatic changes and complications associated with pancreatitis....
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Pvt. Ltd.
2018-07-01
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| Series: | International Journal of Anatomy Radiology and Surgery |
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| Online Access: | http://www.ijars.net/article_fulltext.asp?issn=0973-709x&year=2018&month=July&volume=7&issue=3&page=RO07-RO11&id=2400 |
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| author | Amogh VN Narensatya Srinivas Ravi Kumar Arunchandra Dayanand Kumar |
| author_facet | Amogh VN Narensatya Srinivas Ravi Kumar Arunchandra Dayanand Kumar |
| author_sort | Amogh VN |
| collection | DOAJ |
| description | Introduction: Acute pancreatitis is a disease with high
rate of morbidity and mortality and is known to run an
unpredictable course. CT is the standard non invasive
investigation to evaluate pancreatic parenchymal changes,
peri pancreatic changes and complications associated
with pancreatitis.
Aim: To determine the value of CT evaluation in early
diagnosis of acute pancreatitis and use as baseline imaging
modality. To use modified CT severity grading system to
grade the severity of acute pancreatitis.
Materials and Methods: This is a prospective study
conducted from January 2013 to June 2014. The study
was approved by institutional review board. Patients with
clinically suspected/diagnosed acute pancreatitis, altered
serum amylase, serum lipase and ultrasound diagnosed
cases of acute pancreatitis were included in the study.
The study was conducted using GE16 slice CT scanner
standard protocol, oral and IV contrast were used.
Descriptive statistics (Tabulations, graphs and charts,
proportions, percentage) are used.
Results: About 60 patients were included in our study.
Oedematous pancreatitis was in 28% patients and
pancreatic necrosis was in 25% patients. Features like
diffuse/focal pancreatic enlargement in 76%, peri pancreatic
fat stranding in 63% and peri pancreatic fluid collection in
33%. Modified CT severity index was classified as mild,
moderate and severe of which majority were mild (65%).
The accuracy and sensitivity of serum amylase and serum
lipase in diagnosing AP were 45% and 65%.
Conclusion: CT is a sensitive, non invasive imaging in
early diagnosis and staging of severity of acute pancreatitis
which help in prediction of prognosis of the disease. It helps
to initiate the treatment at earliest in rural areas. It also
helps to differentiate between oedematous and necrotising
pancreatitis, as serum lipase and amylase levels do not help
to differentiate the type of AP. Modified CT severity index
helps in evaluating the percentage pancreatic necrosis and
to predict the possibility of developing local and systemic
complications and necessity of tertiary care. |
| first_indexed | 2024-04-12T14:33:08Z |
| format | Article |
| id | doaj.art-2cabf1eb6f624da5a23fb62713e4bef7 |
| institution | Directory Open Access Journal |
| issn | 2277-8543 2455-6874 |
| language | English |
| last_indexed | 2024-04-12T14:33:08Z |
| publishDate | 2018-07-01 |
| publisher | JCDR Research and Publications Pvt. Ltd. |
| record_format | Article |
| series | International Journal of Anatomy Radiology and Surgery |
| spelling | doaj.art-2cabf1eb6f624da5a23fb62713e4bef72022-12-22T03:29:11ZengJCDR Research and Publications Pvt. Ltd.International Journal of Anatomy Radiology and Surgery2277-85432455-68742018-07-0173RO07RO1110.7860/IJARS/2018/34823:2400Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity IndexAmogh VN0Narensatya Srinivas1Ravi Kumar2Arunchandra3Dayanand Kumar4Assistant Professor, Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India.Assistant Professor, Department of Radiology, MVJ Medical, College, Bengaluru, Karnataka, India.Assistant Professor, Department of Radiology, Apollo Hospital Chittor, Andhra Pradesh, India.Senior Resident, Department of Surgery, MVJ Medical, College, Bengaluru, Karnataka, India.Professor, Department of Radiology, MVJ Medical, College, Bengaluru, Karnataka, IndiaIntroduction: Acute pancreatitis is a disease with high rate of morbidity and mortality and is known to run an unpredictable course. CT is the standard non invasive investigation to evaluate pancreatic parenchymal changes, peri pancreatic changes and complications associated with pancreatitis. Aim: To determine the value of CT evaluation in early diagnosis of acute pancreatitis and use as baseline imaging modality. To use modified CT severity grading system to grade the severity of acute pancreatitis. Materials and Methods: This is a prospective study conducted from January 2013 to June 2014. The study was approved by institutional review board. Patients with clinically suspected/diagnosed acute pancreatitis, altered serum amylase, serum lipase and ultrasound diagnosed cases of acute pancreatitis were included in the study. The study was conducted using GE16 slice CT scanner standard protocol, oral and IV contrast were used. Descriptive statistics (Tabulations, graphs and charts, proportions, percentage) are used. Results: About 60 patients were included in our study. Oedematous pancreatitis was in 28% patients and pancreatic necrosis was in 25% patients. Features like diffuse/focal pancreatic enlargement in 76%, peri pancreatic fat stranding in 63% and peri pancreatic fluid collection in 33%. Modified CT severity index was classified as mild, moderate and severe of which majority were mild (65%). The accuracy and sensitivity of serum amylase and serum lipase in diagnosing AP were 45% and 65%. Conclusion: CT is a sensitive, non invasive imaging in early diagnosis and staging of severity of acute pancreatitis which help in prediction of prognosis of the disease. It helps to initiate the treatment at earliest in rural areas. It also helps to differentiate between oedematous and necrotising pancreatitis, as serum lipase and amylase levels do not help to differentiate the type of AP. Modified CT severity index helps in evaluating the percentage pancreatic necrosis and to predict the possibility of developing local and systemic complications and necessity of tertiary care.http://www.ijars.net/article_fulltext.asp?issn=0973-709x&year=2018&month=July&volume=7&issue=3&page=RO07-RO11&id=2400necrosispancreatic necrosissevirty |
| spellingShingle | Amogh VN Narensatya Srinivas Ravi Kumar Arunchandra Dayanand Kumar Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index International Journal of Anatomy Radiology and Surgery necrosis pancreatic necrosis sevirty |
| title | Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index |
| title_full | Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index |
| title_fullStr | Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index |
| title_full_unstemmed | Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index |
| title_short | Prospective Evaluation of Acute Pancreatitis in Early Diagnosis Using Modified CT Severity Index |
| title_sort | prospective evaluation of acute pancreatitis in early diagnosis using modified ct severity index |
| topic | necrosis pancreatic necrosis sevirty |
| url | http://www.ijars.net/article_fulltext.asp?issn=0973-709x&year=2018&month=July&volume=7&issue=3&page=RO07-RO11&id=2400 |
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