Acute Pancreatitis: What to see
Pancreas / Peripancreatic region:
1. Appearance of the pancreatic gland
2. Enhancement of the pancreatic gland
3.
Peri-pancreatic
inflammation and fluid
4. Pancreatico-biliary tree
5. Pancreatic calcification/mass
Extra Pancreatic
1. Venous thrombosis
2. Arterial complications - hemorrhage / pseudo aneurysm
3. Transverse mesocolon and small bowel mesentery changes.
4. Bowel - thickening / intramural fluid collection
5. Solid organ - infarction / hemorrhage / subcapsular fluid
6. Ascites
7. Pleural effusion
8. Fatty liver
ASSESSMENT ON CT SCAN: Mortele Modified CTSI Scoring:
Pancreatic inflammation:
Normal pancreas - 0 points
Intrinsic abnormality with or without inflamamtory changes in thte peripancreatic fat - 2 points
Pancreatic or peripancreatic collection / peripancreatic fat necrosis - 4 points
Pancreatic Necrosis:
Necrosis absent - 0 points
< 30 % necrosis - 2 points
> 30 % necrosis - 4 points
Extra pancreatic findings - 2 points
Total Score:
Mild pancreatitis - 0 to 2
Moderate pancreatitis - 4 to 6
Severe Pancreatitis - 8 to 10 points
Terminology - Revised Atlanta
Based on timing and location
< 4 weeks
1. Acute Peripancreatic Fluid collections (extra pancreatic)
2. Pseudocyst (extra pancreatic)
> 4 weeks
3. Acute Necrotic collections (Intra or extra pancreatic)
4. Walled off Necrotic Collections (Intra or extra pancreatic)
Prepared By Dr. Sharad Maheshwari
09.03.2023
Updated:
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