Key words: Acute pancreatitis. APACHE-II. Ranson. Balthazar. Correlation. de severidad de la pancreatitis aguda según criterios de Ranson, APACHE-II y. The numerical CTSI has a maximum of ten points, and is the sum of the Balthazar grade points and pancreatic necrosis grade. Acute pancreatitis (AP) is one of the most common diseases of the gastrointestinal tract, leading to Balthazar EJ, Robinson DL, Megibow AJ et al .

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Similar trends in duration of hospital stay, intervention or surgery, evidence of infection, organ failure, and mortality in patients with variable grades of severity of pancreatitis were observed in our study as that seen by Mortele in their study. Many of these patients however will have necrotizing pancreatitis and the mortality increases when the necrosis becomes infected. A critical evaluation of laboratory tests in acute pancreatitis. Modified CT severity index makes the score easier to calculate and reduces the inter-observer variation.

Conclusion Modified CT severity index makes the score easier to calculate and reduces the inter-observer variation. Clinical follow-up of the patients was done in terms of the following parameters:.

Tomografia computadorizada sem contraste intravenoso no abdome agudo: Imaging is pncreatitis during the initial presentation if:. The collection underwent successful percutaneous drainage, which showed clear fluid with high amylase and subsequently resolved along with the patient’s symptoms. There are several ways to help distinguish between these two forms. Journal of the American College of Surgeons. The New England Journal of Medicine. CT is an important common initial assessment tool for acute pancreatitis.

CT of acute pancreatitis: Mumps is a more common cause in adolescents and young adults than in other age groups. The s everity is classified into three categories based on clinical and morphologic findings according to revised Atlanta classification [ 8 ].


The pancreas is swollen and there is peripancreatic inflammation 2 points. The body and tail of the criteris do not enhance. The necrotic debris was too viscous for successful percutaneous drainage.

The s everity is classified into three fe based on clinical and morphologic findings: Disadvantages of a naso-enteric feeding tube include increased risk of sinusitis especially if the tube remains in place greater than two weeks and a still-present risk of accidentally intubating the trachea even in intubated patients contrary to popular belief, the endotracheal tube cuff alone is not always sufficient to prevent NG tube entry into the trachea.

The current management of acute pancreatitis is to be conservative for as long as possible. Abstract Introduction Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. The British Journal of Surgery. The American Journal of Gastroenterology.

CT Evaluation of Acute Pancreatitis and its Prognostic Correlation with CT Severity Index

Significance of extrapancreatic findings in computed tomography CT of acute pancreatitis. The retroperitoneal approach has some advantages:. The advantage of enteral feeding is that it is more physiological, prevents gut mucosal atrophy, and is free from the side effects of TPN such as fungemia.

Most collections that persist after 4 weeks are walled-of-necrosis.

The Radiology Assistant : Pancreas – Acute Pancreatitis

Because fat does not enhance on CT, the diagnosis of fat necrosis can be difficult. Lipase activation produces the necrosis of fat tissue in pancreatic interstitium and peripancreatic spaces as well as vessel damage. No contamination with intestinal flora.

Balthazxr death of pancreatic cells occurs via two main mechanisms: Intrinsic pancreatic abnormalities with or without inflammatory changes in peripancreatic fat. This maybe explained because it is a third level concentration center in which most of the AP patients are looked after in second level centers, therefore our results cannot be extrapolated to the population in general; it would be important to perform this analysis on these kind of attention centers.


Route can be used to guide minimally invasive surgery. It has fluid density and a thin enhancing wall. The retroperitoneal approach has some advantages: There is normal enhancement of pancfeatitis entire pancreatic gland with only mild surrounding fatty infiltration.

Limitations In patients of derange renal function and pregnant patients contrast CT is contraindicated.

Pleural effusion was the most common extra-pancreatic complication with left pleural effusion being the more common. Balthazar C Case 3: The Balthazar CTSI was calculated by adding the above points in each case and the total score was then categorized as:.

Published online Jun 1. World Journal of Gastroenterology.

Acute pancreatitis

A retrospective, balthwzar and analytic study was made. Based on CT alone it is sometimes impossible to determine whether a collection contains fluid only or a mixture of fluid and necrotic tissue.

The possible explanation for this is the large number of patients having mild pancreatitis in their study group. This also correlated with the study by Irshad Ahmad Banday pancreatltis al. Their diagnostic value for acute pancreatitis”. There exist few studies that correlate these parameters. At this stage, it is not possible to distinguish between an acute peripancreatic fluid collection and acute necrotic collection.

Rarely only the pancreatic parenchyma.

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