Utility of 128-slice Multi-detector Spiral Computed Tomography in Detecting Spectrum of Involvement in Acute Pancreatitis
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 4
Abstract
Introduction: Computed tomography (CT) has proved to be invaluable, noninvasive, technique for detailed assessment of pancreas during its acute inflammatory stage. Detailed evaluation, proper staging on scoring basis and prediction of morbidity and mortality are possible with the help of advanced high-resolution multi-detector multislice CT scanner. The purpose of this study is to determine the role and efficacy of CT scan in evaluating spectrum of extent of involvement of pancreas in acute phase irrespective of the etiology. This was a cross-sectional retrospective study of 3 years duration. Aims and Objectives: To evaluate the extent of involvement of pancreatic parenchyma in acute phase of parenchymal inflammation and to diagnose common early and late complications with the prediction of morbidity and mortality. Material and Methods: This was a cross-sectional retrospective study conducted at Government Medial College, Miraj, from June 2014 to May 2017. A total of 150 patients of different age groups presenting with signs and symptoms of acute pancreatitis and with those with altered pancreatic function test were included in this study. Diagnosis was confirmed on clinical, biochemical marker (raised serum amylase and lipase levels), imaging findings and response to the treatment. Results: In our study, acute pancreatitis was more common in males (68%) compared to female population (32%). Most common age group affected by this pathology was 40-60 years age group (58%), and least common age group was more than 80 years (<7%). Most common etiology in males was alcohol abuse (39%) and in females were gall stones (39%). 20-40 age group population was most commonly affected by alcohol induced pancreatitis while 40-60 age group was most commonly affected by gall stones disease. Other causes were seen in <40 age group. The most common finding of acute pancreatitis on CT scan was acute early interstitial edematous pancreatitis (31.4%). Ductal disruption was the least common finding (2%). CT severity index was mild in 38% cases and moderate to severe in 31% each. Conclusion: Early diagnosis and assessment of extent of parenchymal involvement with an assessment of complication and prediction of morbidity and mortality clearly remains a challenge in acute pancreatitis. CT proves itself as a gold standard in such emergency situation and a true winner above all other modalities thus helping the physicians in quality result oriented care of these patients.
Authors and Affiliations
Bharatkumar Mudalgi, Manohar Kachare, Akshay Kulkarni
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