CT Evaluation of Acute Pancreatitis and its Prognostic Correlation with CT Severity Index
Introduction: Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal CT are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagno...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/7934/19849_CE(RA1)_F(T)_PF1(ROAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Pancreatitis is one of most complex and clinically
challenging of all abdominal disorders. USG and abdominal CT
are the most commonly used diagnostic imaging modalities
for the evaluation of pancreas. Computed Tomography (CT) is
highly accurate and sensitive than USG in both diagnosing as
well as demonstrating the extent. Early assessment of the cause
and severity of acute pancreatitis is of utmost importance for
prompt treatment and close monitoring of patient with severe
disease. CT is the imaging method of choice for assessing the
extent of acute pancreatitis and for evaluating complications.
Aim: To assess prognostic correlation and clinical outcome of
acute pancreatitis on the basis of CT severity index.
Materials and Methods: A prospective study of 50 cases was
carried out in the Department of Radio Diagnosis, with complaint suggestive of acute pancreatitis on the basis of clinical/
laboratory/ultrasonography findings were evaluated in Siemens
somatom 40 slice ct. The severity of pancreatitis was scored
using CT severity index, modified severity index and revised
Atlanta classification and classified into mild, moderate, severe
categories. Clinical follow-up of the patients was done in terms
of the following parameters: Length of hospital stay, Need for
surgery or percutaneous intervention, Evidence of infection in
any organ system, Occurrence of organ failure- respiratory,
cardiovascular, renal, hepatic and haematological system,
death. The clinical outcome was compared with the currently
accepted Balthazar’s CTSI and Modified Mortele’s CTSI and
revised Atlanta classification in all the cases.
Results: Gall stone disease was most common aetiological
factor seen in 40% cases, it was more common in females
than males. Alcohol was second most common aetiological
factor seen in 38% cases and was noted only in males. Pleural
effusion was the most common extra-pancreatic complication
seen in 46% cases. Balthazar grade C was the most common
(40%) followed by grade D and E (25% each). Acute peripancreatic collection was the most common findings seen in
72% cases. Majority of the cases (42%) were categorized as
mild pancreatitis according Balthazar CTSI score. Majority of the
cases (44%) were categorized as severe pancreatitis according
modified CTSI. Majority of the cases were categorized as mild
pancreatitis according revised Atlanta classification. Organ
system failure, death were more seen in severe grade in modified
CTSI and revised Atlanta classification.
Conclusion: Modified CT severity index makes the score easier
to calculate and reduces the inter-observer variation. Scores
obtained with the modified Mortele index, show a stronger
statistical correlation for all clinical outcome parameters in all
the patients better than the Balthazar index. |
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| ISSN: | 2249-782X 0973-709X |