scholarly journals A variation of colon cut off sign in acute pancreatitis and its mechanism: Double cut-off sign

2017 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Nisa Cem Ören ◽  
Osman Cancuri ◽  
Murat Kocaoğlu ◽  
Nail Bulakbaşı
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Transverse Colon ◽  
Distal Colon ◽  
Abdominal Radiograph

The colon cutoff sign is a single air-filled loop of transverse colon with abrupt termination of the distal colon. We report an acute pancreatitis case with colon “double” cut-off sign appears both on abdominal radiograph and computed tomography.

scholarly journals Computed Tomography Findings in Intraabdominal Hypertension in Patients with Acute Pancreatitis

2021 ◽  
Author(s):  
Pankaj Gupta ◽  
Rohan Kamat ◽  
Jayanta Samanta ◽  
Harshal Mandavdhare ◽  
Vishal Sharma ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Severe Disease ◽  
Univariate Analysis ◽  
Tissue Perfusion ◽  
Intraabdominal Pressure ◽  
Biliary Dilatation ◽  
Ct Findings ◽  
Contrast Enhanced Ct ◽  
Intraabdominal Hypertension

Abstract Purpose Intraabdominal hypertension (IAH) in acute pancreatitis (AP) may reduce tissue perfusion and impair organ function and has been shown to portend poor prognosis. We investigated the computed tomography (CT) findings in patients with AP with IAH. Methods This retrospective study comprised of consecutive patients with AP from June 2016 to June 2018 in whom intraabdominal pressure (IAP) was measured. The patients who underwent a contrast-enhanced CT within 7 days of IAP measurement were included. Using a cutoff of 12 mm Hg for IAP, the patients were divided into IAH and non-IAH groups. Measures of severity and clinical outcome were evaluated. CT parameters were compared between the groups. Results The IAH group comprised of 41 patients, while there were 20 patients in the non-IAH group. The IAH group was characterized by severe disease, increased incidence of organ failure, increased requirement for drainage and surgery, prolonged hospital and intensive care unit stay. The mortality was not significantly different between the two groups. On univariate analysis, the CT features that were found to be significantly different between the two groups were the presence of collection (p = 0.036), the maximum dimension of collection (p = 0.004), volume of collection (p = 0.019), biliary dilatation (p = 0.011), and the presence of moderate-to-severe pleural effusion (p = 0.009). On multivariate analysis, all these parameters except biliary dilatation were found to be statistically significant. Conclusion CT findings in patients with AP may suggest IAH. This can be used as an additional marker for severity of AP.

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

Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis

2004 ◽  
Vol 126 (3) ◽  
pp. 715-723 ◽  
Author(s):  
Marianna Arvanitakis ◽  
Myriam Delhaye ◽  
Viviane De Maertelaere ◽  
Monia Bali ◽  
Catherine Winant ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Magnetic Resonance ◽  
Resonance Imaging

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

Usefulness of perfusion computed tomography for early detection of pancreatic ischemia in severe acute pancreatitis

2006 ◽  
Vol 21 (9) ◽  
pp. 1506-1508 ◽  
Author(s):  
Yoshihisa Tsuji ◽  
Yuji Watanabe ◽  
Kazuhiro Matsueda ◽  
Hiroyuki Yamamoto ◽  
Etsuji Ishida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Early Detection ◽  
Severe Acute Pancreatitis ◽  
Perfusion Computed Tomography ◽  
Pancreatic Ischemia

scholarly journals AUTOPSY FEATURES AT THE ACUTE DESTRUCTIVE PANCREATITIS

2020 ◽  
Vol 28 (2) ◽  
pp. 48-54
Author(s):  
Al'fiya K. Imayeva ◽  
Tagir I. Mustafin
Keyword(s):  
Acute Pancreatitis ◽  
Transverse Colon ◽  
Infectious Agent ◽  
Pathological Process ◽  
Postmortem Examination ◽  
Retroperitoneal Space ◽  
Contrast Study ◽  
Type I ◽  
Type Iii ◽  
The Right

In all variants of the destructive form of pancreatitis, the involvement of adipose tissue of both para-pancreatic and distant localization was noted. In this case, it is necessary to improve the pathological diagnosis of acute destructive pancreatitis. The aim of the study was to develop new techniques for postmortem examination of those who died from complications of acute pancreatitis. Pathological studies were supplemented by the methods proposed by the authors, which made it possible to clarify the spread of the infectious agent through the retroperitoneal tissue. The scheme proposed by the authors for recording changes in the tissue of the pancreas and surrounding tissues after a contrast study made it possible to clarify the main ways of propagation of the purulent-necrotic process along the retroperitoneal tissue. The results of postmortem examination of 67 deaths from complications of acute pancreatitis are presented. Based on the study, 5 types of acute destructive pancreatitis were identified. In type I, the pathological process involves the right half of the retroperitoneal tissue, including the mesentery root of the small intestine, the para-pancreatic region, the right para-kidney and sub-hepatic space. The second type is characterized by the presence of inflammatory and destructive changes in the fiber of the right lateral canal, the actual retroperitoneal space on the right and the mesentery root of the transverse colon. Purulent-necrotic changes in para-pancreatic, left perineal tissue, mesentery of the transverse colon, also in peritoneum were typical for type III acute destructive pancreatitis. For type IV disease, in addition to areas of involvement as in type III, involvement of the pelvic tissue and the left sections of the retroperitoneal space itself were noted. The spread of the infectious agent to both the right and left parts of the retroperitoneal tissue was defined as type V acute destructive pancreatitis.

scholarly journals Pancreaticopleural fistula: An insidious cause of pleural effusion –case report

2021 ◽  
Author(s):  
Fábio Murteira ◽  
Tiago Costa ◽  
Sara Barbosa Pinto ◽  
Elsa Francisco ◽  
Ana Catarina Gomes
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Case Report ◽  
Pleural Effusion ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Pancreatic Amylase ◽  
Pleural Effusions ◽  
Primary Event ◽  
Endoscopic Retrograde ◽  
Left Chest

Pancreaticopleural fistulas (PPF) are a rare etiology of pleural effusions. We describe a case of a 61-year-old man, with left chest pain with six months of progression who presented with a large volume unilateral pleural effusion. A thoracentesis was performed, which showed a dark reddish fluid(exudate) and high content of pancreatic amylase. After that an abdominal computed tomography (CT)and magnetic resonance cholangiopancreatography (MRCP) was done, revealing fistulous pathways that originated in the pancreas. The patient was admitted for conservative and endoscopic treatment by Endoscopic Retrograde Cholangiopancreatography (ERCP) and a prosthesis was placed on a fistulous path. He was discharged without complications, with the resolution of the pleural effusion and fistula.The interest of this case lies in the rarity of the event and absence of symptoms of the probable primary event (acute pancreatitis). The possible iatrogenic association with several drugs of his usual medication makes it even more complex.

scholarly journals Computed Tomography Evaluation of Acute Pancreatitis and Its Complications – A Prospective Study at a Tertiary Referral Center

2021 ◽  
Vol 8 (11) ◽  
pp. 643-647
Author(s):  
Rama Krishna Narra ◽  
Manjeera Boddepalli ◽  
Narasimhachary Munjuwanpalli ◽  
Bhimeswarao Pasupaleti
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Prospective Study ◽  
Pancreatic Necrosis ◽  
Contrast Enhanced ◽  
Necrotising Pancreatitis ◽  
Enhanced Computed Tomography ◽  
A Prospective Study ◽  
Contrast Enhanced Computed Tomography ◽  
Score Index

BACKGROUND Acute pancreatitis (AP) is described as acute inflammation of the pancreas with or without peripancreatic abnormalities. The present study describes the role of computed tomography in the evaluation and grading of acute pancreatitis. Acute pancreatitis is a dynamic disease having biphasic mortality peaks due to two overlapping phases, which include early and late due to increased obesity, ageing of population, alcohol abuse, increased gall stone incidence, the worldwide AP incidence is increasing. Most important causes of AP in developing countries such as India include increased alcohol consumption. Contrast enhanced computed tomography plays an important role in diagnosis of the disease and helps in determining the prognosis of the disease. Modified CT severity index scoring system is the most commonly used scoring system for assessment of the severity of the disease. METHODS The present study is a prospective study of patients presenting with signs and symptoms of acute pancreatitis referred to the Department of Radio Diagnosis at Katuri medical college. This study comprised of 50 patients with clinical suspicion / diagnosis of acute pancreatitis, raised pancreatic biochemical parameters like serum amylase and serum lipase. Contrast enhanced computed tomography was performed in these patients, findings reported, and the disease was classified using modified CT scoring index system (MCTSI). RESULTS The mean age of the patients in the present study was 42.3 ± 12.28 years. Most of the patients presented with abdominal epigastric pain, abdominal distension. Acute pancreatitis was divided into acute oedematous pancreatitis and necrotising pancreatitis, the former being common. Complications included, ascites, pleural effusions, splenic vein thrombosis, portal venous thrombosis, and haemorrhages. CONCLUSIONS Contrast enhanced CT is useful to differentiate between oedematous and necrotising types of pancreatitis. The MCTSI helps in better evaluation of pancreatic necrosis grading. The modified computed tomography score index correlation with the development of local and systemic complications in acute pancreatitis is well established. Ideally, conducting contrast enhanced computed tomography (CECT) after 48 - 72 hours of acute attack, increases the probability of identifying necrotising pancreatitis. CT in particular has an overall accuracy of about 87 % and sensitivity and specificity of 100 % in the recognition of pancreatic necrosis. KEYWORDS Computed Tomography, Acute Pancreatitis, Pseudocyst, Modified CT Score Index

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