Early diagnosis of Acute pancreatitis with modified CT severity index

Acute pancreatitis is a life-threatening condition with significant morbidity and mortality and is known to run an unpredictable course. This study was performed to determine the value of computed tomography evaluation in early diagnosis of acute pancreatitis, differentiate between acute edematous and acute necrotizing pancreatitis, grade the percentage of necrosis and to grade the disease based on modified computed tomography severity index. A prospective study on 60 cases of acute pancreatitis was conducted to evaluate CT in the early diagnosis of acute pancreatitis and its use as a primary imaging modality for AP diagnosis based on the CT severity index. MCTSI was classified as mild, moderate and severe. Plain and post-contrast series of the abdomen and pelvis were taken.

After analyzing the image, MCTSI graded the disease into grades 2,4,6,8 and 10. Results showed that 28% of patients had oedematous pancreatitis, and 25% of patients suffered from pancreatic necrosis. Features like diffuse/focal pancreatic enlargement, peri pancreatic fat stranding and peri pancreatic fluid collection were seen in 76%, 63% and 33% of patients respectively. The majority of the patients had mild acute pancreatitis (65%). Also, the accuracy and sensitivity of serum amylase and serum lipase in diagnosing acute pancreatitis were 45% and 65% respectively. Thus, Modified CT severity index can be used to predict the possibility of developing local and systemic complications and necessity of tertiary care. MCTSI grading correlates directly with the development of local and systemic complications.

Journal name : International Journal of Anatomy, Radiology and Surgery.

Name of researcher : Amogh VN, Naren Satya SM, Ravi kumar, Arunchandra, Dayanand kumar.

Date : 2018 July