scholarly journals Role of Computed Tomography In The Evaluation of Severity of Acute Pancreatitis

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 738-744
Author(s):  
Md Mofazzal Sharif ◽  
Mahfuz Ara Ferdousi ◽  
Md Towhidur Rahman ◽  
Nayeema Rahman ◽  
Md Nayeem Ullah ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Clinical Outcome ◽  
Surgical Intervention ◽  
Gall Stone ◽  
Severity Index ◽  
Clinical Findings ◽  
Time Period ◽  
Mild Acute Pancreatitis

Title: Role of computed tomography in the evaluation of severity of acute pancreatitis.Introduction: Early diagnosis and determination of severity of acute pancreatitis is important for management and it depends largely on severity of disease. Medical treatment of mild acute pancreatitis includes conservative management while severe acute pancreatitis requires intensive care to surgical intervention (open or minimally invasive) in selected cases.Methodology: This prospective study was carried out to find out the correlation between modified CT severity index and patient's clinical outcome in acute pancreatitis enrolling 96 subjects in the department of Radiology and Imaging, BIRDEM during two years time period. Severity of acute pancreatitis was assessed by both clinical and imaging staging (Modified CT severity index) in mild, moderate and severe groups.Result: Mean age ( ± SD) of the study subjects was 35.48 ± 14.59 years and number of male was 60 (62.50%) and female was 36 (37.50%). Acute pancreatitis was associated with hypertriglyceridemia (19.79%), gall stone (12.5%), post ERCP (6.25%) and alcoholism (2.08%). Aetiology was unidentified in 59.73% subjects. Majority of the subjects with acute pancreatitis presented with abdominal pain, fever (20.08%), vomiting (54.41%) and oedema (25%). On imaging, diffuse pancreatic enlargement was noted in 29.16% subjects. Pancreatic inflammation with and without peripancreatic fat involvement were observed in 27.08% and 72.91% subjects respectively. Pseudocyst formation (13.54%), ascites (30.20%), renal fascia involvement (46.87%) and pleural effusion (37.5%) were seen in CT scan. Severity of acute pancreatitis was evaluated by clinical findings and CT severity index and the measure of agreement between clinical and imaging staging was almost perfect. CT severity index in acute pancreatitis had statically significant relation with clinical outcome (0.573), organ failure (0.674), need for surgical intervention (0.463) and hospital stay (0.235).Conclusion: Modified CT severity index in acute pancreatitis correlates with patient outcome. During reporting if this simple scoring system is applied then we can easily measure the severity and determine whether patient need medical or surgical intervention.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 738-744

Advantages of Modified Computed Tomography Severity Index of Acute Pancreatitis Over Other Scoring System

KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
Md Mofazzal Sharif ◽  
Khaleda Parvin Rekha ◽  
Umme Iffat Siddiqua ◽  
Mst Monira Khatun ◽  
AKM Enamul Haque ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Clinical Outcome ◽  
Severe Disease ◽  
Severity Index ◽  
Observer Variation ◽  
Imaging Method ◽  
Close Monitoring ◽  
Early Assessment ◽  
Prompt Treatment

Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal Computed Tomography (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. CT severity index is used to assess prognostic correlation and clinical outcome of acute pancreatitis. Modified CT severity index makes the score easier to calculate and reduces the inter-observer variation. KYAMC Journal Vol. 10, No.-2, July 2019, Page 110-113

scholarly journals Comparison of CT Severity Index and Modified CT Severity Index in the Clinical Severity Assessment of Acute Pancreatitis

2021 ◽  
Author(s):  
Piyaporn Apisarnthanarak ◽  
Pattira Boonsri ◽  
Voraparee Suvannarerg ◽  
Walailak Chaiyasoot ◽  
Supot Pongprasobchai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Cohort Study ◽  
Clinical Outcome ◽  
Severity Index ◽  
Fair Agreement ◽  
Clinical Severity ◽  
Critical Groups ◽  
Severity Assessment ◽  
Poor Clinical Outcome

Objective: To compare the computed tomography severity index (CTSI) and the modified computed tomography severity index (MCTSI) in the clinical severity assessment of acute pancreatitis.Material and Methods: This retrospective cohort study comprised acute pancreatitis patients who underwent contrastenhanced abdominal computed tomography (CT) scans within 4 weeks after clinical onset. Two experienced abdominal radiologists, blinded to the clinical outcome, independently reviewed the CT images and retrospectively scored them using CTSI and MCTSI. Any discrepancies were resolved by a consensus review. The clinical severity assessment of each participant was categorized by the determinant-based classification of acute pancreatitis severity. The correlations of CTSI and MCTSI with the clinical severity assessment were analyzed.Results: This cohort study consisted of 40 participants—28 of them were men (70.0%)—with a mean age of 59.3 years. They were clinically divided into mild, moderate, severe, and critical groups comprising 11 (27.5%), 16 (40.0%), 7 (17.5%), and 6 (15.0%) participants, respectively. Due to the small number of patients in the severe and critical groups, we combined these into a single severe category (13 patients, 32.5%). The CTSI and MCTSI scores showed moderate and fair agreement with the clinical severity assessment. A trend linking poor clinical outcome with high CTSI/MCTSI scores (moderate and severe groups) more commonly than low scores (mild group) was observed. There was a very strong agreement between CTSI and MCTSI (rs =0.97).Conclusion: CTSI and MCTSI showed a moderate and fair agreement, respectively, with the clinical severity assessment. Compared to low scores, a poor clinical outcome was more often associated with high CTSI/MCTSI scores.

scholarly journals Relation of Pancreatic Enzymes and Serum Transaminases Levels with Modified CT Severity Index In Acute Pancreatitis

2016 ◽  
pp. 18-24
Author(s):  
Md Mofazzal Sharif ◽  
Md Towhidur Rahman ◽  
Mahfuz Ara Ferdousi ◽  
Md Abu Taher ◽  
Farzana Shegufta ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Computer Software ◽  
Clinical Information ◽  
Severity Index ◽  
Clinical Findings ◽  
Perfect Agreement ◽  
Female Ratio ◽  
Imaging Department ◽  
Mild Acute Pancreatitis

Introduction: Diagnosis of patients with severe acute pancreatitis as soon as possible is critical for achieving optimal outcomes. Management depends largely on severity. Medical treatment of mild acute pancreatitis is relatively straightforward. Treatment of severe acute pancreatitis involves intensive care. Surgical intervention (open or minimally invasive) is indicated in selected cases.Methodology: A total number of 59 subjects were enrolled in this present prospective study in the department of Radiology and Imaging, BIRDEM during two years aim to find out the correlation between CT severity index and patient serum enzyme levels in acute pancreatitis. Patients with clinically suspected and biochemically diagnosed acute pancreatitis referred to Radiology and Imaging department from department of gastroenterology (GHPD), BIRDEM for imaging investigation were enrolled in this study. Severity of acute pancreatitis was measured by both clinical and imaging staging (Modified CT severity index) in mild, moderate and severe groups. Subjects clinical information’s and serum enzymes were recorded and analyzed by computer software SPSS (Ver. 20-IBM).Result: Mean age of the study subjects was 36.43 ± 13.85 years. The age ranged from 20-63 years and the maximum number was found in 21 to 40 years age group. Male female ratio was almost 1.56:1. It was seen that diffuse pancreatic enlargement was noted in 20.33% subjects. Pancreatic inflammation with and without peripancreatic fat involvement were observed in 22.72% and 57.62% subjects respectively. Pseudocyst formation (11.86%), ascites (23.72%), renal fascia involvement (37.28%) and pleural effusion (30.5%) were seen in CT scan. The results of the interpreter analysis was Kappa = 0.852 with p < 0.001 when association of severity by clinical scoring and CT severity scoring was compared and revealed that measure of agreement, while statistically significant, was almost perfect agreement. CT severity index in acute pancreatitis had statistically significant (p is less than 0.05) relation with serum amylase (0.738), lipase (0.638), SGOT (0.581) and SGPT (0.365) during admission which was found on simple linear regression test.Conclusion: This present study concluded that modified CT severity index correlated well with patient’s enzymes level (Amylase, lipase, SGOT, SGPT) as well as clinical findings in acute pancreatitisBirdem Med J 2015; 5(1) Supplement: 18-24

scholarly journals Role of total calcium and corrected calcium in comparisons with computed tomography to predict severity of acute pancreatitis

2020 ◽  
Vol 7 (2) ◽  
pp. 399
Author(s):  
Anjali Thakur ◽  
Gitanjali Goyal ◽  
Simmi Aggarwal ◽  
Sarabjeet Singh
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Age Groups ◽  
Severity Index ◽  
Significant Negative Correlation ◽  
Medical College ◽  
R Value ◽  
Rule Out

Background: The objective of the study was to evaluate corrected calcium levels in patient of acute pancreatitis and to evaluate role of corrected calcium as predictor of severity in acute pancreatitis in comparison to computed tomography (CT) scan.Methods: The study was conducted in Department of Biochemistry of G.G.S Medical College in collaboration with the Department of Surgery and Department of Radio diagnosis. 50 patients, with clinical diagnosis of acute pancreatitis, attending the Inpatient Department of Department of Surgery, were taken. 50 patients, of either sex of 18 to 70 age groups suffering from acute pancreatitis were enrolled for the study.Results: On exploring the data, highly significant negative correlation found between CT severity index (CTSI) and serum calcium (p≤0.001; r value=-0.520) whereas the non-significant correlation found between CTSI and amylase (p=0.778; r value=-0.041). The corrected calcium and CTSI shows highly negative significant correlation (p≤0.001; r value=-0.654). Serum albumin with CTSI also shows significant correlation (p=0.006; r value=0.385). But no significant association with lipase (p≥0.05).Conclusions: We observed that corrected calcium and calcium is better and alternative marker for predicating the severity of disease because corrected calcium and calcium is having good positive predictive value to indicate progression of damage and also a highly significant negative predictive value to rule out severity of acute pancreatitis. 

scholarly journals Role of Computed Tomography in Predicting Severity of Acute Pancreatitis and its Correlation with Clinical Outcome

2019 ◽  
Vol 6 (2) ◽  
Author(s):  
Kapil Sawarkar ◽  
Pramod Shaha ◽  
Ruchi Narayan ◽  
Dhruv Chavan ◽  
Dhanashree More ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Clinical Outcome

Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

Sign in / Sign up

Export Citation Format

Share Document