What to report in a case of Acute Pancreatitis - Quick review

 

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: