Acute Pancreatitis, its Complications and Prognostic Correlation by Modified CT Severity Index

Transcription

1 Acute Pancreatitis, its Complications and Prognostic Correlation by Modified CT Severity Index Poster No.: R-0022 Congress: RANZCR-AOCR 2012 Type: Scientific Exhibit Authors: K. P. Bellam Premnath, K. Taori, A. Disawal, N. Kundargi Keywords: Abdomen, CT, Complications, Inflammation DOI: /ranzcraocr2012/R-0022 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 18

2 Purpose 1.To evaluate patient of pancreatitis by computed tomography in terms of: Morphology of pancreas in Acute pancreatitis Acute edematous / necrotizing pancreatitis. Complications of pancreatitis likepseudocyst, abscess, GI andbiliarytract and vascular complications (Pseudoaneurysmand Venous thrombosis) etc. Prognostic correlation by Modified CT severity index (CTSI). 2.To define common etiologies and age incidence. 3.To define Incidence of various complications of acute pancreatitis. Page 2 of 18

3 Methods and Materials Study - for 1years from June 2010 to May 2011 Sample size Age distribution from years CT SCAN MACHINE : Multidetector CT Somatom Volume Access; Siemens Medical system, Forchiem, Germany. Page 3 of 18

4 Images for this section: Fig. 1: Siemens multislice CT machine Page 4 of 18

5 Results Acute pancreatitis Acute Pancreatitis is an inflammatory process of pancreas with intrapancreatic activation of enzymes from acinar cells into surrounding tissues. It is a common disease that causes significant morbidity and mortality. Pathologic changes vary from acute edema and cellular infiltration to necrosis of the acinar cells, hemorrhage from necrotic blood vessels, and intra- and extrapancreatic fat necrosis. There are various causes with alcoholism and gall stone disease being the most common. Males and the age group 31 to 40 were most commonly affected. 39% patients developed complications of which pseudocysts, necrosis and vascular complications were the most common % of pseudocysts got complicated by infection or hemorrhage. Duration of hospital stay and complications increased with higher degree of pancreatitis according to modified CT severity index. Overall mortality was 6 % most commonly due to SIRS (systemic inflammatory response syndrome) followed by MODS (multi organ dysfunction syndrome) Page 5 of 18

6 Images for this section: Fig. 2: Modified CT severity index Page 6 of 18

7 Fig. 3: Normal pancreas in CT Page 7 of 18

8 Fig. 4: Mild pancreatitis Page 8 of 18

9 Fig. 5: Moderate pancreatitis Page 9 of 18

10 Fig. 6: Severe pancreatitis with necrosis Page 10 of 18

11 Fig. 7: Pseudocyst Page 11 of 18

12 Fig. 8: Pancreatic abscess Page 12 of 18

13 Fig. 9: Splenic artery pseudoaneurysm Page 13 of 18

14 Fig. 10: Duration of hospital stay vs severity of pancreatitis Fig. 11: Morbidity and mortality versus severity Page 14 of 18

15 Page 15 of 18

16 Conclusion 1)CT is the most sensitive and specific imaging modality for the evaluation of acute pancreatitis and its complication.2)the modified CT severity index has a stronger prognostic correlation and could also predict the length of hospital stay and development of organ failure.3)alcohol found to be the most common etiology in current study.4)among all complications Infected necrosis has highest mortality rates.5)morbidity in terms of no of days in hospital were higher compared to reference studies. Page 16 of 18

17 Personal Information Page 17 of 18

18 References Acute Pancreatitis in a Multi-Ethnic Population P Kandasami, Hanafiah Harunarashid, Harjit Kaur -Singapore Med J 2002 Vol 43(6) : Complications of acute pancreatitis Clinical and CT evaluation Emil J. Balthazar, MD Radiol Clin N Am 40 (2002) Necrotizing Pancreatitis: Diagnosis and Management John C. Haney, MD, MPH, Theodore N. Pappas, MD* Surg Clin N Am 87 (2007) Pseudocyst Formation in Acute Pancreatitis: Ultrasonographic Evaluation of 99 Cases A. C. Gonzalez,1 e. L. Bradley,2 and j. L. Clements, jr.1 Am J Roentgenol 1 27 : Can ultrasound predict the severity of acute pancreatitis early by observing acute fluid collection? Yan Luo1, Chao Xin Yuan1, Yu Lan Peng1, Pei Lin Wei1, Zhao Da Zhang2, Jun Ming Jiang3, Lin Dai1 and Yun Kai Hu1 World J Gastroentero, 2001;7(2): Page 18 of 18