Updated Imaging Nomenclature for Acute Pancreatitis
|
|
- Myles Bennett
- 6 years ago
- Views:
Transcription
1 Residents Section Structured Review Murphy et al. Imaging Nomenclature for Acute Pancreatitis Residents Section Structured Review Residents inradiology Kevin P. Murphy 1,2 Owen J. O Connor 1,2 Michael M. Maher 1,2 Murphy KP, O Connor OJ, Maher MM Keywords: acute pancreatitis, Atlanta Classification, CT, pancreas imaging, pancreatic collection DOI: /AJR Received November 5, 2013; accepted after revision April 15, Department of Radiology, Cork University Hospital, Wilton, Cork, Ireland. Address correspondence to M. M. Maher (m.maher@ucc.ie). 2 Department of Radiology, University College Cork, Cork, Ireland. WEB This is a web exclusive article. AJR 2014; 203:W464 W X/14/2035 W464 American Roentgen Ray Society Updated Imaging Nomenclature for Acute Pancreatitis KEY POINTS 1. CT is used to confirm the diagnosis of acute pancreatitis when the diagnosis is in doubt and to differentiate acute interstitial pancreatitis from necrotizing pancreatitis, which is a key element of the updated Atlanta nomenclature. The acute interstitial variety accounts for 90 95% of cases, with acute necrotizing pancreatitis accounting for the remaining cases. 2. Necrosis due to acute pancreatitis is best assessed on IV contrast-enhanced CT performed 40 seconds after injection. Peripancreatic necrosis is a subtype of necrotizing pancreatitis in which tissue death occurs in peripancreatic tissues. This is seen in isolation in 20% of patients with necrotizing pancreatitis. 3. Simple fluid collections associated with acute interstitial pancreatitis are subdivided chronologically. A collection observed within approximately 4 weeks of acute pancreatitis onset is termed an acute peripancreatic fluid collection (APFC). A collection older than 4 weeks should have a thin wall and is termed a pseudocyst. Both APFCs and pseudocysts can be infected or sterile. 4. Fluid collections associated with necrotizing pancreatitis are labeled on the basis of age and the presence of a capsule. Within 4 weeks of acute pancreatitis onset, a fluid collection associated with necrotizing pancreatitis is termed an acute necrotic collection (ANC) whereas an older collection is termed an area of walled-off necrosis (WON) if it has a perceptible wall on CT. The term pseudocyst is not used in the setting of necrotizing pancreatitis collections. Although an ANC and a (WON can be infected or sterile, infection is far more likely compared with acute interstitial pancreatitis collections. 5. The severity of acute pancreatitis is graded on the basis of the presence of acute complications or organ failure. Mild acute pancreatitis has neither acute complications nor organ failure. Moderate-severity acute pancreatitis is associated with acute complications or organ failure lasting fewer than 48 hours. Severe acute pancreatitis is characterized by single- or multiorgan failure persisting for greater than 48 hours. R adiology plays an integral part in the assessment and management of acute pancreatitis. The 1992 Atlanta Classification System of acute pancreatitis was revised in 2012 by the Atlanta Working Group in conjunction with 11 national and international pancreatic societies [1, 2]. Familiarity with the revised nomenclature is essential for accurate communication of imaging findings. In this article, we summarize the updated nomenclature and illustrate corresponding imaging findings using relevant cases. Disease Epidemiology Acute pancreatitis remains a common reason for hospital admission, with a prevalence of per 100,000 people per year [3 7]. Furthermore, the incidence of acute pancreatitis is increasing. Per-patient mortality has improved, but population mortality from acute pancreatitis remains around 6 18 per million per year [3 7], with a per-case mortality rate of approximately 6%. Pathophysiologic Basis Gallstones and alcohol account for the majority of cases of acute pancreatitis [3, 5, 7 9]. Interestingly, a cause is not found in up to one third of cases [8]. The typical clinical history is one of acute constant severe epigastric pain that radiates through to the back. There may be associated vomiting, abdominal distention, tenderness, tachycar- W464 AJR:203, November 2014
2 Imaging Nomenclature for Acute Pancreatitis Fig. 1 Axial T2-weighted image from MRCP study in 26-year-old woman with gallstone-associated acute interstitial pancreatitis shows gallstones in gallbladder (arrowhead) and common bile duct (arrow). dia, dehydration, or pyrexia. The presence of at least two of the following three conditions is required to fulfill the clinical criteria for acute pancreatitis: acute upper abdominal pain consistent with acute pancreatitis, serum amylase or lipase of at least three times the normal level (ranges: lipase, IU/L; amylase, IU/L), or typical CT findings [2, 10, 11]. Regardless of the cause, cellular injury of the exocrine acinar cells leads to intracellular digestive enzyme activation (trypsin and proteases predominantly). After enzyme activation, cellular damage leads to systemic release of digestive enzymes, inciting edema, ischemia, and potentially necrosis and liquefaction. This in turn incites a cytokine cascade worsening local inflammation and complications and potentially leading to a systemic inflammatory response syndrome (SIRS) with potential for organ failure. Acute pancreatitis is divided into two phases: early and late [2, 12]. The early phase of acute pancreatitis lasts for 1 week and is characterized by activation of the cytokine cascade with resultant SIRS. SIRS is present when the patient exhibits two or more of the following: heart rate greater than 90 beats/min, temperature less than 36 C or greater than 38 C, respiratory rate greater than 20/min, PCO 2 less than 32 mm of mercury, or WBC less than 4 or greater than /L. Persisting systemic signs of inflammation or local complications constitute late-phase acute pancreatitis. This begins from the end of week 1 after symptom onset and lasts for several weeks or even months. The late phase is rarely seen in mild acute pancreatitis. Treatment of patients during the Fig. 3 Coronal CT reconstruction image in 59-year-old man with acute interstitial pancreatitis shows peripancreatic fat stranding (arrowheads), and two small acute peripancreatic fluid collections (arrows) are visible. Fig. 4 CT image in 43-year-old man with alcoholassociated necrotizing pancreatitis shows parenchymal (arrow) and peripancreatic (arrowheads) necrosis. Fig. 2 Axial IV contrast-enhanced CT image in 46-year-old man with acute interstitial pancreatitis shows small acute peripancreatic fluid collection (arrows), mild diffuse enlargement of pancreas, and surrounding fat stranding. AJR:203, November 2014 W465
3 Murphy et al. Fig. 5 CT image in 36-year-old woman with pseudocyst shows contents of pseudocyst are simple in appearance (arrowhead), and thin capsule is observed (arrow) after episode of acute interstitial pancreatitis. early phase of acute pancreatitis is largely based on clinical parameters, but imaging is particularly important to guide treatment of acute pancreatitis during the late phase. Imaging Approach CT is the imaging modality of choice to assess acute pancreatitis and identify associated local complications. Routine CT use is, however, not warranted to confirm the diagnosis or to assess severity. Imaging is not required for the diagnosis of acute pancreatitis if the patient has an appropriate history of abdominal pain and sufficiently elevated serum amylase or lipase. CT can be used to confirm the diagnosis when one Fig. 6 Axial contrast-enhanced CT image in 44-year-old woman with acute necrotic collection shows contents are of mixed attenuation, consistent with complex contents (arrows). of two diagnostic criteria are absent in a patient with suspected pancreatitis. CT is indicated to exclude malignancy in patients greater than 40 years old who develop acute pancreatitis for the first time without an identifiable cause. In addition, imaging to assess disease severity is not required if clinical and biochemical parameters indicate that acute pancreatitis is not severe and if the patient shows sufficient clinical improvement over the first 24 hours. The optimal time for assessing acute complications of acute pancreatitis is approximately 72 hours after symptom onset [11, 12]. Contrast-enhanced CT is the modality of choice for this indication. Unenhanced and pancreatic phases (40 seconds after IV contrast administration) are recommended to accurately assess for necrosis and complications. CT can also provide information pertaining to the type and cause of acute pancreatitis and guidance for management. Performance of further CT should be guided by the patient s clinical and biochemical findings, requirement to check catheter position, or response to treatment. CT is used more commonly than ultrasound to guide interventional procedures to treat pancreatic infective complications of acute pancreatitis largely because of the retroperitoneal location of the pancreas. More superficial infected collections can often be accessed with ultrasound guid- A Fig year-old man with gallstone-associated necrotic pancreatitis. A, CT image shows peripancreatic and pancreatic necrosis (arrowheads) along with large acute necrotic collection (ANC) (arrows). B, Follow-up CT image shows two percutaneous drains (arrowheads) have been placed in interim to drain ANC (arrows), which has reduced in size since initial CT. B W466 AJR:203, November 2014
4 Imaging Nomenclature for Acute Pancreatitis Fig. 8 Axial contrast-enhanced CT image in 40-year-old woman with necrotizing pancreatitis shows walled-off necrosis with heterogeneous contents (arrow). No gas is seen within collection to suggest infection. ance. Percutaneous drains can be upsized to enable minimally invasive retroperitoneal necrosectomy (step-up approach), where required [7, 13]. Ultrasound and MRI are adjuncts to CT in the appraisal and management of acute pancreatitis. They are predominantly used for the diagnosis of cholelithiasis or cholodocholithiasis and in the assessment of the contents and internal architecture of collections (Fig. 1). Imaging Appearance Differentiating Acute Interstitial Pancreatitis From Necrotizing Pancreatitis Contrast-enhanced CT is used to evaluate the severity and type of acute pancreatitis, particularly in cases in which the Fig. 9 Ultrasound image in 37-year-old man with acute necrotic collection (ANC) shows complex collection as evidenced by internal echogenic debris within ANC (arrows). severity of acute pancreatitis appears moderate or severe or necrosis is suspected. In acute interstitial pancreatitis, the pancreatic parenchyma enhances homogeneously, the peripancreatic fat usually shows some stranding, and a peripancreatic fluid collection may be seen (Figs. 2 and 3). In patients with necrotizing acute pancreatitis, three subtypes can be seen: necrosis of pancreatic parenchyma with sparing of peripancreatic tissues (5%), necrosis of peripancreatic tissue with parenchymal sparing (20%), or involvement of both (75%) [2, 12, 14] (Fig. 4). Patients with peripancreatic necrosis alone have a better prognosis than those with parenchymal involvement but not as good as patients with acute interstitial pancreatitis. CT can be indeterminate for the classification of acute pancreatitis because of heterogeneous pancreatic enhancement, and in this setting repeated CT studies after an interval of between 5 and 7 days should be considered. CT best detects parenchymal necrosis around 72 hours after symptom onset. After unenhanced and pancreatic phase imaging, an area of necrosis is seen as a relatively heterogeneous focus with intermediate attenuation but with no enhancement after contrast administration. After approximately 1 week, the necrotic zone becomes better demarcated and attenuation decreased as its contents liquefy [2, 12]. The percentage of necrotic parenchyma should be estimated because it has Fig. 10 Ultrasound image in 46-year-old woman with walled-off necrosis shows collection is mildly complex with internal echoes (arrows). A definite capsule is evident posteriorly (arrowheads). Fig. 11 Coronal T2-weighted image acquired at MRCP in 54-year-old man with pseudocyst shows internal contents are simple in appearance. Some irregularity of capsule wall (arrows) is seen. AJR:203, November 2014 W467
5 Murphy et al. Fig. 12 Axial contrast-enhanced CT image in 58-year-old man with necrotizing pancreatitis shows gas-containing infected walled-off necrosis (WON) anterior to left kidney adjacent to pancreatic body and tail (arrow). Further WON is seen posterior to left kidney (arrowhead) that does not contain gas pockets. prognostic significance. Peripancreatic necrosis most commonly involves retroperitoneal fat but is more difficult to detect than parenchymal necrosis. Contrast-enhanced CT features include areas of heterogeneous peripancreatic enhancement that contain liquefied low-attenuation and nonliquefied intermediate-attenuation components. < 4 Weeks APFC Interstitial edematous pancreatitis > 4 Weeks pseudocyst Acute pancreatitis Collections Associated With Acute Interstitial Pancreatitis Collections associated with acute interstitial pancreatitis are subclassified on the basis of the length of time between symptom onset and development of the collection, the presence of a wall surrounding the collection, or the presence of infection. In the initial 4 weeks after development of acute interstitial pancreatitis, a nonencapsulated fluid seen surrounding the pancreas should be termed an acute peripancreatic fluid collection (APFC) [2] (Figs. 2 and 3). On CT, the contents are uniformly hypoattenuating, devoid of solid components, and nonenhancing in appearance. The walls are imperceptible and conform to adjacent structures. APFCs usually resolve spontaneously and do not normally require drainage. After approximately 4 weeks, if the collections persist, a nonepithelialized capsule encompasses these fluid collections and can be observed on CT. Simple collections that have developed perceptible walls within 4 weeks of symptom onset in the setting of APFCs can be characterized as pseudocysts on imaging (Fig. 5). Again, as for APFCs the contents should be simple in appearance. An infected APFC or pseudocyst is uncommon but should be suspected on imaging if gas is seen within the collection. Fluid collections associated with acute interstitial pancreatitis should only be located in peripancreatic tissues. If a collection has an intraparenchymal component then by definition it must be related to necrotizing pancreatitis. Hence, use of the term intraparenchymal pseudocyst is no longer recommended. < 4 Weeks ANC Necrotizing pancreatitis, pancreatic necrosis, or peripancreatic necrosis Fig. 13 Axial contrast-enhanced CT image in 41-year-old woman with infected gas-containing walled-off necrosis shows percutaneous drain in position (arrow). Splenic vein is thrombosed with resultant venous collaterals in left upper quadrant and epigastrium related to stomach (arrowheads). > 4 Weeks WON Collections Associated With Necrotizing Pancreatitis Fluid collections occurring in or around the pancreas within 4 weeks of the onset of necrotizing pancreatitis are termed acute necrotic collections (ANCs) [2] (Figs. 4, 6, and 7). On imaging, ANCs may be observed within or surrounding the pancreas or both. An ANC is characterized on CT by the presence of a heterogeneous collection containing hemorrhage, fat, or necrotic fat occurring in the presence of acute necrotic pancreatitis. ANCs can appear homogeneous and nonenhancing during the first week after symptom onset, but after 1 week, liquefied contents become more obvious. Over time, an enhancing wall develops around an ANC, and if 4 weeks have elapsed since symptom origin, the collection is termed an area of walledoff necrosis (WON) [2] (Fig. 8). The internal contents of an ANC or WON are complex because of the presence of necrotic tissue that results in variable attenuation on CT. MRI or ultrasound may be required to confirm the Fig. 14 Flowchart shows key terminology in new Atlanta pancreatitis nomenclature. Initial differentiation is into interstitial edematous and necrotizing pancreatitis. Details of their associated collections are also outlined. The 4-week time frame for alteration in collection type is approximation and not only criterion used to define evolution. APFC = acute pancreatic fluid collection, ANC = acute necrotic collection, WON = walled-off necrosis. W468 AJR:203, November 2014
6 Imaging Nomenclature for Acute Pancreatitis nature of the contents and help differentiate an ANC or WON from an APFC or pseudocyst (Figs. 9 11). Communication with the pancreatic duct may also be evident on CT or MRI. This may alter management but does not affect lesion classification. Infection affects the classification of acute pancreatitis. Infection is more likely in an ANC or WON than in an APFC or pseudocyst. Terms such as phlegmon, pancreatic abscess, organized necrosis, sequestration, or necroma should no longer be used. The presence of gas within a collection is highly suggestive of infection (Figs. 12 and 13). If clinical findings are concordant or needle-guided aspiration confirms the presence of infection, these collections are classified as an infected ANC or infected WON depending on the time frame. Air within a collection can be misinterpreted as an abscess if there is communication between the collection and the gastrointestinal tract. Suspicion for infection should therefore be correlated with the patient s clinical examination and biochemical profile and, if necessary, percutaneous fine-needle aspiration should be used to obtain a fluid sample for confirmation [2, 7, 11 13]. Aspiration has a false-negative rate of approximately 10%. If pus is aspirated, percutaneous drain insertion should be performed for the treatment of an infected collection (Figs. 7B and 13). Severity of Acute Pancreatitis Acute pancreatitis severity is divided into mild, moderate, and severe varieties. The parameters used to prescribe these divisions are the presence of organ failure or the presence of local or systemic complications [2, 15]. The new guidelines recommend assessment of renal, cardiovascular, and respiratory system dysfunction via the Modified Marshall Scoring System [2]. CT assessment is of crucial importance in evaluating for local complications and hence stratification of severity. In mild pancreatitis, no end-organ dysfunction or complications are present. Most cases of mild acute pancreatitis are of the acute interstitial variety, have a good prognosis, and usually do not require CT [2]. Moderate severity pancreatitis has organ failure that lasts for fewer than 48 hours and may or may not have local or systemic complications. Severe pancreatitis is characterized by single- or multiorgan failure that persists for greater than 48 hours. The severity of acute pancreatitis can change over a 24-hour period, leading to alteration in the severity score. Conclusion The updated Atlanta Classification attempts to standardize and clarify the nomenclature used to describe acute pancreatitis to improve communication between care providers and to facilitate comparison of new management strategies for acute pancreatitis and outcome in different centers. A clear distinction is made between acute interstitial pancreatitis and necrotizing pancreatitis. (Fig. 14) Collections associated with acute interstitial pancreatitis are termed APFCs in the first 4 weeks after symptom onset and pseudocysts after approximately 4 weeks, once a capsule develops. On the other hand, collections associated with necrotizing pancreatitis are termed ANCs and WON before and after a capsule forms (approximately 4 weeks after symptom onset). In both ANC and WON, the 4-week time frame is an estimation of the length of time required for the peripheries of the collection to become organized and a perceptible wall to become visible on imaging, but the age of the collection is not an absolute requirement. The updated guidelines also confirm stratification of acute pancreatitis into mild, moderate, or severe varieties according to the presence of organ failure and complications. Finally, another important aspect of the updated Atlanta Classification is the identification of early (1 2 weeks) and late (weeks to months) phases of acute pancreatitis. Familiarity and use of this new terminology by radiologists is key to assessing, staging, and managing patients with acute pancreatitis. This system helps health care providers to standardize treatment, communicate imaging appearances using common terminology, and hopefully improve patient outcomes. References 1. Bradley EL. A clinically based classification system for acute pancreatitis: summary of the International Symposium on Acute Pancreatitis, Atlanta, GA, September 11 through 13, Arch Surg 1993; 128: Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis 2012: revision of the Atlanta Classification and definitions by international consensus. Gut 2013; 62: Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas 2006; 33: Vidarsdottir H, Möller PH, Vidarsdottir H, Thorarinsdottir H, Björnsson ES. Acute pancreatitis: a prospective study on incidence, etiology, and outcome. Eur J Gastroenterol Hepatol 2013; 25: Roberts SE, Akbari A, Thorne K, Atkinson M, Evans PA. The incidence of acute pancreatitis: impact of social deprivation, alcohol consumption, seasonal and demographic factors. Aliment Pharmacol Ther 2013; 38: Spanier B, Bruno MJ, Dijkgraaf MG. Incidence and mortality of acute and chronic pancreatitis in the Netherlands: a nationwide record-linked cohort study for the years World J Gastroenterol 2013; 28: Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology guideline: management of acute pancreatitis. Am J Gastroenterol 2013; 108: Chen Y, Zak Y, Hernandez-Boussard T, Park W, Visser BC. The epidemiology of idiopathic acute pancreatitis, analysis of the nationwide inpatient sample from 1998 to Pancreas 2013; 42: Yadav D, Lowenfels AB. The epidemiology of pancreatitis and pancreatic cancer. Gastroenterology 2013; 144: Sarr MG. IAP guidelines in acute pancreatitis. Dig Surg 2003; 20: Working Party of the British Society of Gastroenterology, Association of Surgeons of Great Britain and Ireland, Pancreatic Society of Great Britain and Ireland, and Association of Upper GI Surgeons of Great Britain and Ireland. UK guidelines for the management of acute pancreatitis. Gut 2005; 54(suppl 3):iii1 iii9 12. Thoeni RF. The revised Atlanta Classification of acute pancreatitis: its importance for the radiologist and its effect on treatment. Radiology 2012; 262: Sarr MG revision of the Atlanta Classification of acute pancreatitis. Pol Arch Med Wewn 2013; 123: van Santvoort HC, Besselink MG, Bakker OJ, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med 2010; 362: Dellinger EP, Forsmark CE, Layer P, et al. Determinant-based classification of acute pancreatitis severity: an international multidisciplinary consultation. Ann Surg 2012; 256: AJR:203, November 2014 W469
ACUTE PANCREATITIS: NEW CLASSIFICATION OF AN OLD FOE. T Barrow, A Nasrullah, S Liong, V Rudralingam, S A Sukumar
ACUTE PANCREATITIS: NEW CLASSIFICATION OF AN OLD FOE T Barrow, A Nasrullah, S Liong, V Rudralingam, S A Sukumar LEARNING OBJECTIVES q Through a series of cases illustrate the updated Atlanta symposium
More informationAcute Pancreatitis: Review of Updated Atlanta Classification and Its Advantages
Acute Pancreatitis: Review of Updated Atlanta Classification and Its Advantages Poster No.: C-1880 Congress: ECR 2014 Type: Educational Exhibit Authors: U. Koç, B. De#irmenci, A. R. Aktas; Isparta/TR Keywords:
More informationU Nordic Forum - Trauma & Emergency Radiology. Lecture Objectives. MDCT in Acute Pancreatitis. Acute Pancreatitis: Etiologies
Nordic Forum - Trauma & Emergency Radiology Lecture Objectives MDCT in Acute Pancreatitis Borut Marincek Institute of Diagnostic Radiology niversity Hospital Zurich, Switzerland To describe the role of
More informationACG Clinical Guideline: Management of Acute Pancreatitis
ACG Clinical Guideline: Management of Acute Pancreatitis Scott Tenner, MD, MPH, FACG 1, John Baillie, MB, ChB, FRCP, FACG 2, John DeWitt, MD, FACG 3 and Santhi Swaroop Vege, MD, FACG 4 1 State University
More informationRole of Imaging Methods in Diagnosis of Acute Pancreatitis. Válek V. Radiologická klinika, FN Brno a LF MU v Brně
Role of Imaging Methods in Diagnosis of Acute Pancreatitis Válek V. Radiologická klinika, FN Brno a LF MU v Brně New Classification: Acute Pancreatitis 2007 revision of Atlanta classification and definitions
More informationLocal complications in acute pancreatitis: what's radiologically new, according to the revised Atlanta classification (2012).
Local complications in acute pancreatitis: what's radiologically new, according to the revised Atlanta classification (2012). Poster No.: C-1252 Congress: ECR 2016 Type: Authors: Keywords: DOI: Educational
More informationSevere necrotizing pancreatitis. ICU Fellowship Training Radboudumc
Severe necrotizing pancreatitis ICU Fellowship Training Radboudumc Acute pancreatitis Patients with acute pancreatitis van Dijk SM. Gut 2017;66:2024-2032 Diagnosis Revised Atlanta classification Abdominal
More informationEmergency Surgery Course Graz, March ACUTE PANCREATITIS. Carlos Mesquita Coimbra
ACUTE PANCREATITIS Carlos Mesquita Coimbra ESSENTIALS (1) AP occurs when digestive enzymes become activated while still in the pancreas, causing inflammation repeated bouts of AP can lead to chronic pancreatitis
More informationIMAGING OF ACUTE AND CHRONIC PANCREATITIS, INCLUDING EXOCRINE FUNCTION
IMAGING OF ACUTE AND CHRONIC PANCREATITIS, INCLUDING EXOCRINE FUNCTION Andrew T. Trout, MD @AndrewTroutMD Disclosures Grant support National Pancreas Foundation In-kind support - ChiRhoClin modified from:
More informationMild. Moderate. Severe
2012 Revised Atlanta Classification Acute pancreatitis Classified based on absence or presence of local and/or systemic complications Mild Acute Pancreatits Moderate Severe P. A. Banks, T. L. Bollen, C.
More informationPANCREATIC PSEUDOCYSTS. Madhuri Rao MD PGY-5 Kings County Hospital Center
PANCREATIC PSEUDOCYSTS Madhuri Rao MD PGY-5 Kings County Hospital Center 34 yo M Case Presentation PMH: Chronic pancreatitis (ETOH related) PSH: Nil Meds: Nil NKDA www.downstatesurgery.org Symptoms o Chronic
More informationAcute pancreatitis is most commonly caused by gallstones
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2008;6:1077 1085 CLINICAL IMAGING Imaging of Acute Pancreatitis and Its Complications DESIREE E. MORGAN Department of Radiology, University of Alabama at Birmingham,
More informationA Prospective Study of Bedside Index for Severity in Acute Pancreatitis Score in Acute Pancreatitis
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/210 A Prospective Study of Bedside Index for Severity in Acute Pancreatitis Score in Acute Pancreatitis S Kasturi Bai
More informationHajhamad M 1, Reynu R, Kosai NR, Mustafa MT, Othman H 2
Successful conservative management of pancreatico-colonic fistula following videoscopic assisted retroperitoneal debridement of infected pancreatic necrosis. Case report and review of literature. Hajhamad
More informationDoes it matter what we drain?
Endoscopic Management of Pancreatic Fluid Collections Shyam Varadarajulu, MD Medical Director Center for Interventional Endoscopy Florida Hospital, Orlando Does it matter what we drain? Makes all the difference!
More informationAcute Pancreatitis: New Developments and Strategies for the Hospitalist
REVIEWS Acute Pancreatitis: New Developments and Strategies for the Hospitalist John F. Dick, III, MD 1 *, Timothy B. Gardner, MD, MS 2, Edward J. Merrens, MD, MS 1 1 Geisel School of Medicine, Section
More informationEndoscopic pancreatic necrosectomy in 2017
Endoscopic pancreatic necrosectomy in 2017 Mouen Khashab, MD Associate Professor of Medicine Director of Therapeutic Endoscopy The Johns Hopkins Hospital Revised Atlanta Classification Entity Acute fluid
More informationX-ray Corner. Imaging of The Pancreas. Pantongrag-Brown L
X-ray Corner 125 Imaging of The Pancreas Modern imaging modalities commonly used in pancreas include ultrasound (US), CT, and MRI. Pancreas is a retroperitoneal organ which makes it difficult to visualize
More informationImaging Techniques for Acute Necrotizing Pancreatitis: Multidetector Computed Tomography
AISP - 29 th National Congress. Bologna (Italy). September 15-17, 2005. Imaging Techniques for Acute Necrotizing Pancreatitis: Multidetector Computed Tomography Lucia Calculli 1, Raffaele Pezzilli 2, Riccardo
More informationPancreatic Benign April 27, 2016
Department of Surgery Pancreatic Benign April 27, 2016 James Choi Dr. Hernandez Objectives Medical Expert: 1. Anatomy and congenital anomalies of the pancreas and pancreatic duct (divisum, annular pancreas
More informationCorrespondence should be addressed to Supot Pongprasobchai;
Hindawi Gastroenterology Research and Practice Volume 2017, Article ID 3525349, 7 pages https://doi.org/10.1155/2017/3525349 Research Article Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand:
More informationClinical profile, degree of severity and underlying factors of acute pancreatitis among a group of Bangladeshi patients
Clinical profile, degree of severity and underlying factors of acute pancreatitis among a group of Bangladeshi patients Indrajit Kumar Datta 1, Md Nazmul Haque 1, Tareq M Bhuiyan 2 Original Article 1 Deaprtment
More informationImaging of Acute Pancreatitis
Residents Section Structured Review rticle O Connor et al. Imaging of cute Pancreatitis Residents Section Structured Review rticle Residents inradiology Owen J. O Connor 1 Sebastian McWilliams 1 Michael
More informationEvidence based imaging of the pancreas
Evidence based imaging of the pancreas D.Vanbeckevoort, D.Bielen, K.Op de beeck, R.Vanslembrouck Department of Radiology Chairman Prof. Dr. R.Oyen Non-invasive imaging tests available for the diagnosis
More informationCommon and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review
Review Article Common and unusual CT and MRI manifestations of pancreatic adenocarcinoma: a pictorial review Min-Jie Yang, Su Li, Yong-Guang Liu, Na Jiao, Jing-Shan Gong Department of Radiology, Shenzhen
More informationAnatomical and Functional MRI of the Pancreas
Anatomical and Functional MRI of the Pancreas MA Bali, MD, T Metens, PhD Erasme Hospital Free University of Brussels Belgium mbali@ulb.ac.be Introduction The use of MRI to investigate the pancreas has
More informationImaging of the Complications of Acute Pancreatitis
Residents Section Structured Review O Connor et al. Complications of cute Pancreatitis Residents Section Structured Review Downloaded from www.ajronline.org by 46.3.192.72 on 01/02/18 from IP address 46.3.192.72.
More informationCorrespondence should be addressed to Justin Cochrane;
Case Reports in Gastrointestinal Medicine Volume 2015, Article ID 794282, 4 pages http://dx.doi.org/10.1155/2015/794282 Case Report Acute on Chronic Pancreatitis Causing a Highway to the Colon with Subsequent
More informationCOMPUTED TOMOGRAPHY FINDINGS IN ACUTE PANCREATITIS
ORIGINAL ARTICLE COMPUTED TOMOGRAPHY FINDINGS IN ACUTE PANCREATITIS Noorul Hadi, Kalsoom Nawab, Ayesha Amin Department Of Radiology, Post Graduate Medical Institute, Hayatabad Medical Complex, Peshawar
More informationAcute pancreatitis complications and a method to improve the outcome
Acute pancreatitis complications and a method to improve the outcome Poster No.: C-2959 Congress: ECR 2017 Type: Authors: Keywords: DOI: Scientific Exhibit B. Angheloiu, A. Leandru; Brasov/RO Abdomen,
More informationSiddharth Gosavi, Vydehi Institute of Medical Sciences & Research Centre, India Under the guidance of Gillian Lieberman, MD
Under the guidance of Gillian Lieberman, MD March 2016 RADIOLOGICAL HALLMARKS OF NECROTIZING PANCREATITIS Siddharth Gosavi, Vydehi Institute of Medical Sciences & Research Centre, India Under the guidance
More informationDisclosures. Extra-hepatic Biliary Disease and the Pancreas. Objectives. Pancreatitis 10/3/2018. No relevant financial disclosures to report
Extra-hepatic Biliary Disease and the Pancreas Disclosures No relevant financial disclosures to report Jeffrey Coughenour MD FACS Clinical Associate Professor of Surgery and Emergency Medicine Division
More informationCase Discussion Splenic Abscess
Case Discussion Splenic Abscess Personal Data Gender: male Birth Date: 1928/Mar/06th Allergy: Mefenamic Smoking: 0.5 PPD for 55 years Alcohol: negative (?) 4 Months Ago Abdominal pain: epigastric area
More informationCT 101 :Pancreas and Spleen
CT 101 :Pancreas and Spleen Shikha Khullar,, MD, MPH Division of Radiology University of South Alabama The Pancreas Normal Pancreas 3 Phase Pancreatic CT Non contrast Arterial phase : 30-35 35 second
More informationAcute pancreatitis Case reports. Clinical problems. Use of antibiotics? (P 1 & 2) Surgical treatment of AP? (P 3 & 4)
Case reports Clinical problems Use of antibiotics? (P 1 & 2) Surgical treatment of AP? (P 3 & 4) Case reports Case 1 Case 1 Patient KD History M, 63 y Obesity BMI 30.3 kg/m 2 Gallbladder stones No concomitant
More informationPerformance of the revised Atlanta and determinant-based classifications for severity in acute pancreatitis
Original article Performance of the revised Atlanta and determinant-based classifications for severity in acute pancreatitis S. S. Bansal 1, J. Hodson 2, R. S. Sutcliffe 1, R. Marudanayagam 1, P. Muiesan
More informationJOHN M UECKER, MD, FACS COMPLEX PANCREATICODUODENAL INJURIES
JOHN M UECKER, MD, FACS COMPLEX PANCREATICODUODENAL INJURIES THE PROBLEM DUODENAL / PANCREATIC INJURIES Difficult to diagnose Not very common Anatomic and physiologic challenges 90% rate of associated
More informationCLINICAL CASE OF THE MONTH. A 35 Year Old Woman with Abdominal Pain
CASE REPORT JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY CLINICAL CASE OF THE MONTH A 35 Year Old Woman with Abdominal Pain Melissa Spera, MD, Camille Thelin, MD, Abby Gandolfi, MD, Nicholas Clayton,
More informationVIDEO ASSISTED RETROPERITONEAL DEBRIDEMENT IN HUGE INFECTED PANCREATIC PSEUDOCYST
Trakia Journal of Sciences, Vol. 13, Suppl. 2, pp 102-106, 2015 Copyright 2015 Trakia University Available online at: http://www.uni-sz.bg ISSN 1313-7050 (print) doi:10.15547/tjs.2015.s.02.022 ISSN 1313-3551
More informationJournal of Medical Imaging and Radiation Oncology
Journal of Medical Imaging and Radiation Oncology 62 (2018) 504 511 MEDICAL IMAGING PICTORIAL ESSAY Imaging in pancreas transplantation complications: Temporal classification Paula Gallego Ferrero and
More informationJMSCR Vol 04 Issue 08 Page August 2016
www.jmscr.igmpublication.org Impact Factor 5.244 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: http://dx.doi.org/10.18535/jmscr/v4i8.08 Acute Pancreatitis with Normal Amylase
More informationOriginal Article. Abstract. Introduction
Original Article Role of Computed Tomography in Acute Pancreatitis and its Complications among Age Groups Ishtiaq Ahmed Chishty, Vaqar Bari, Sajida Pasha, Dawar Burhan, Zishan Haider, Zafar Rafique Radiology
More informationEndoscopic Management of Acute Pancreatitis. Theo Doukides, MD Gastroenterology and Therapeutic Endoscopy February 13, 2018
Endoscopic Management of Acute Pancreatitis Theo Doukides, MD Gastroenterology and Therapeutic Endoscopy February 13, 2018 Objectives Assessment of acute pancreatitis Early management Who needs an ERCP
More informationAcute Necrotizing Pancreatitis: Laboratory, Clinical, and Imaging Findings as Predictors of Patient Outcome
Gastrointestinal Imaging Original Research Brand et al. Acute Necrotizing Pancreatitis Gastrointestinal Imaging Original Research Michael Brand 1 Andrea Götz 1 Florian Zeman 2 Gundula Behrens 3 Michael
More informationCASE 01 LA Path Slide Seminar 13 March, 08. Deepti Dhall, MD Department of Pathology and Laboratory Medicine Cedars-Sinai Medical Center
CASE 01 LA Path Slide Seminar 13 March, 08 Deepti Dhall, MD Department of Pathology and Laboratory Medicine Cedars-Sinai Medical Center Clinical History 60 year old male presented with obstructive jaundice
More informationAcute Pancreatitis. Falk Symposium 161 Dresden
Acute Pancreatitis Falk Symposium 161 Dresden 12.10.2007 Incidence of Acute Pancreatitis (Malmö) Lindkvist B, et al Clin Gastroenterol Hepatol 2004;2:831-837 Gallstones Alcohol AGA Medical Position Statement
More informationPANCREATIC PSEUDOCYST DRAINAGE: ENDOSCOPIC APPROACHES & THE NURSING ROLE. PRESENTED BY: Susan DePasquale, CGRN, MSN
PANCREATIC PSEUDOCYST DRAINAGE: ENDOSCOPIC APPROACHES & THE NURSING ROLE PRESENTED BY: Susan DePasquale, CGRN, MSN Pancreatic Fluid Collection (PFC) A result of pancreatic duct (PD) and side branch disruption,
More informationTHE CLINICAL course of severe
ORIGINAL ARTICLE Improved Prediction of Outcome in Patients With Severe Acute Pancreatitis by the APACHE II Score at 48 Hours After Hospital Admission Compared With the at Admission Arif A. Khan, MD; Dilip
More informationAcute Pancreatitis: Assessment of Severity with Clinical and CT Evaluation 1
Review Emil J. Balthazar, MD Index terms: Pancreas, CT, 770.12111, 770.12112 Pancreatitis, 770.291 Review Published online before print 10.1148/radiol.2233010680 Radiology 2002; 223:603 613 Abbreviations:
More informationOriginal Article. Gastrointestinal bleeding in acute pancreatitis: etiology, clinical features, risk factors and outcome
Tropical Gastroenterology 2015;36(1):31 35 Original Article Gastrointestinal bleeding in acute pancreatitis: etiology, clinical features, risk factors and outcome Surinder S Rana 1, Vishal Sharma 1, Deepak
More informationProphylactic Antibiotics in Severe Acute Pancreatitis: Antibiotics are good. Karen Lo R 3 University of Colorado Oct 11, 2010
Prophylactic Antibiotics in Severe Acute Pancreatitis: Antibiotics are good Karen Lo R 3 University of Colorado Oct 11, 2010 Overview Pancreas: The History Pancreas: The Organ The Disease Pathogenesis
More informationBiliary tree dilation - and now what?
Biliary tree dilation - and now what? Poster No.: C-1767 Congress: ECR 2012 Type: Educational Exhibit Authors: I. Ferreira, A. B. Ramos, S. Magalhães, M. Certo; Porto/PT Keywords: Pathology, Diagnostic
More informationAnubhav Harshit Kumar* and Mahavir Singh Griwan ORIGINAL ARTICLE. Abstract. Department of Surgery, Pt. B. D. Sharma PGIMS, Rohtak, India
Gastroenterology Report, 2017, 1 5 doi: 10.1093/gastro/gox029 Original article ORIGINAL ARTICLE A comparison of APACHE II, BISAP, Ranson s score and modified CTSI in predicting the severity of acute pancreatitis
More informationComparison of Different Scoring System in Predicting the Severity and Prognosis of Acute Pancreatitis
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 17, Issue 5 Ver. 3 (May. 2018), PP 56-60 www.iosrjournals.org Comparison of Different Scoring System
More informationBackground. RUQ Ultrasound Normal, Recommend Clinical Correlation. Sohail R. Shah, MD, MSHA, FACS, FAAP Texas Children s Hosptial
RUQ Ultrasound Normal, Recommend Clinical Correlation Sohail R. Shah, MD, MSHA, FACS, FAAP Texas Children s Hosptial Background Incidence of pediatric gallbladder disease continues to rise U.S. Pediatric
More informationACUTE PANCREATITIS IN BERGEN, NORWAY
Scandinavian Journal of Surgery 93: 29 33, 2004 ACUTE PANCREATITIS IN BERGEN, NORWAY A study on incidence, etiology and severity H. Gislason 2, A. Horn 1, D. Hoem 1, Å. Andrén-Sandberg 1, A. K. Imsland
More informationImaging of common diseases of hepatobiliary and GI system
Imaging of common diseases of hepatobiliary and GI system Natthaporn Tanpowpong, M.D. Diagnostic radiology Faculty of Medicine, Chulalongkorn University Normal plain radiograph A = Common bile duct
More informationCase Scenario 1. Discharge Summary
Case Scenario 1 Discharge Summary A 69-year-old woman was on vacation and noted that she was becoming jaundiced. Two months prior to leaving on that trip, she had had a workup that included an abdominal
More informationManagement of Acute Pancreatitis and its Complications Aspirus Grand Rounds June 6, 2017 Eric A. Johnson MD
Management of Acute Pancreatitis and its Complications Aspirus Grand Rounds June 6, 2017 Eric A. Johnson MD Disclosure: None In accordance with the Standards of the Wisconsin Medical Society, all those
More informationMy Patient Has Abdominal Pain PoCUS of the Biliary Tract and the Urinary Tract
My Patient Has Abdominal Pain PoCUS of the Biliary Tract and the Urinary Tract Objectives PoCUS for Biliary Disease PoCUS for Renal Colic PoCUS for Urinary Retention Biliary Disease A patient presents
More informationImaging Guided Biopsy. Edited & Presented by ; Hussien A.B ALI DINAR. Msc Lecturer,Reporting Sonographer
Imaging Guided Biopsy Edited & Presented by ; Hussien A.B ALI DINAR. Msc Lecturer,Reporting Sonographer Objective By the End of this lessons you should : Define what biopsy Justify Aim to perform biopsy
More informationLumen Apposing Metal Stents: Expanding the Role of the Interventional Endoscopist. Alireza Sedarat, MD UCLA Division of Digestive Diseases
Lumen Apposing Metal Stents: Expanding the Role of the Interventional Endoscopist Alireza Sedarat, MD UCLA Division of Digestive Diseases Disclosures Consultant for Boston Scientific and Olympus Corporation
More informationIdentification of Serum mirnas as prospective Bio-markers for acute and chronic pancreatitis Dr. Jeyaparvathi Somasundaram
Identification of Serum mirnas as prospective Bio-markers for acute and chronic pancreatitis Dr. Jeyaparvathi Somasundaram Assistant Professor, Department of Biotechnoloy, Lady Doak College, Madurai. Acute
More informationAcute Pancreatitis:
American College of Gastroenterology 2014 Acute Pancreatitis Scott Tenner, MD, MPH, FACG Clinical Professor of Medicine State University of New York Health Sciences Center Director, Brooklyn Gastroenterology
More informationAutoimmune Pancreatitis: A Great Imitator
Massachusetts General Hospital Harvard Medical School Autoimmune Pancreatitis: A Great Imitator Dushyant V Sahani MD dsahani@partners.org Autoimmune Pancreatitis: Learning Objectives Clinical manifestations
More informationOptimizing the step-up approach for infected necrotizing pancreatitis van Grinsven, A.H.J.
UvA-DARE (Digital Academic Repository) Optimizing the step-up approach for infected necrotizing pancreatitis van Grinsven, A.H.J. Link to publication Citation for published version (APA): van Grinsven,
More informationA Retrospective & Prospective Comprehensive Study of Acute Pancreatitis (Diagnosis, Course & Managment)
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 15, Issue 5 Ver. X (May. 2016), PP 15-19 www.iosrjournals.org A Retrospective & Prospective Comprehensive
More informationRole of computed tomography and magnetic resonance imaging in local complications of acute pancreatitis
Review Article Role of computed tomography and magnetic resonance imaging in local complications of acute pancreatitis Emanuele Grassedonio 1, Patrizia Toia 1, Ludovico La Grutta 1, Stefano Palmucci 2,
More informationSurgical Management of Acute Pancreatitis
Surgical Management of Acute Pancreatitis Steven J. Hughes, MD, FACS Cracchiolo Family Professor of Surgery and Chief, General Surgery Overview Biliary pancreatitis a cost effective algorithm Key concepts
More informationPancreatitis. Acute Pancreatitis
Pancreatitis Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas
More informationImaging of liver and pancreas
Imaging of liver and pancreas.. Disease of the liver Focal liver disease Diffusion liver disease Focal liver disease Benign Cyst Abscess Hemangioma FNH Hepatic adenoma HCC Malignant Fibrolamellar carcinoma
More informationCase report Solid pseudopapillary tumor: a rare neoplasm of the pancreas
Gastroenterology Report 2 (2014) 145 149, doi:10.1093/gastro/gou006 Advance access publication 28 February 2014 Case report Solid pseudopapillary tumor: a rare neoplasm of the pancreas Asim Shuja 1, *
More informationThe Pancreas. Basic Anatomy. Endocrine pancreas. Exocrine pancreas. Pancreas vasculature. Islets of Langerhans. Acinar cells Ductal System
SGNA: Back to Basics Rogelio G. Silva, MD Assistant Clinical Professor of Medicine University of Illinois at Chicago Department of Medicine Division of Gastroenterology Advocate Christ Medical Center GI
More informationPrognostic Indicator in Severe Acute Pancreatitis
Open Access Journal Research Article DOI: 10.23958/ijirms/vol03-i05/10 Prognostic Indicator in Severe Acute Pancreatitis Dr. Ajay Khanolkar 1, Dr. Manish Khare *2 1 Associate Professor, 2 Assistant Professor
More informationVascular complications in percutaneous biliary interventions: A series of 111 procedures
Vascular complications in percutaneous biliary interventions: A series of 111 procedures Poster No.: C-0744 Congress: ECR 2013 Type: Educational Exhibit Authors: A. BHARADWAZ; AARHUS, Re/DK Keywords: Obstruction
More informationMulti modality Imaging in Acute Pancreatitis. Marsha Lynch, HMS III Gillian Lieberman, MD BIDMC Core Clerkship in Radiology March 2009
Multi modality Imaging in Acute Pancreatitis Marsha Lynch, HMS III Gillian Lieberman, MD BIDMC Core Clerkship in Radiology March 2009 Our Patient R: Introduction 52M with 10d history of nausea, vomiting
More informationRole of amylase and lipase in diagnosis of acute pancreatitis
Original research Role of amylase and lipase in diagnosis of acute pancreatitis Lavanya Lagisetty 1,*, and Radhika Chowdary D 1. 1 Department Laboratory Medicine, Krishna Institute of Medical Sciences,
More informationPATHOLOGY MCQs. The Pancreas
PATHOLOGY MCQs The Pancreas A patient with cystic fibrosis is characteristically: A. more than 45 years of age B. subject to recurring pulmonary infections C. obese D. subject to spontaneous fractures
More informationDiagnosis of chronic Pancreatitis. Christoph Beglinger, University Hospital Basel, Switzerland
Diagnosis of chronic Pancreatitis Christoph Beglinger, University Hospital Basel, Switzerland Pancreatitis Pancreas Pancreas - an organ that makes bicarbonate to neutralize gastric acid, enzymes to digest
More informationMultidetector CT evaluation of acute pancreatitis and its complications and its correlation with clinical outcome
INTERNATIONAL JOURNAL OF CURRENT RESEARCH IN BIOLOGY AND MEDICINE ISSN: 2455-944X www.darshanpublishers.com DOI:10.22192/ijcrbm Volume 3, Issue 1-2018 Original Research Article Multidetector CT evaluation
More informationPrognostic intraoperative factors in severe acute pancreatitis
Prognostic intraoperative factors in severe acute pancreatitis Popa CC Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Surgery, 2 nd Surgery Clinic, University Emergency
More informationPancreas composed of 2 parts: 1- exocrine gland 2- endocrine gland
pancreas Pancreas composed of 2 parts: 1- exocrine gland 2- endocrine gland Acute pancreatitis Inflammation of the pancreas associated with acinar cell injury Clinical features: 1-abdominal pain cardinal
More informationVascular Imaging in the Pediatric Abdomen. Jonathan Swanson, MD
Vascular Imaging in the Pediatric Abdomen Jonathan Swanson, MD Goals and Objectives To understand the imaging approach, appearance, and clinical manifestations of the common pediatric abdominal vascular
More informationINTRAUTERINE DEVICE = IUD INTRAUTERINE DEVICE = IUD CONGENITAL DISORDERS Pyometra = pyometrea is a uterine infection, it is accumulation of purulent material in the uterine cavity. Ultrasound is usually
More informationINTERDISCIPLINARY DISCUSSIONS IN LOCALISED RCC DIAGNOSIS AND SURGICAL STRATEGIES FOR ATYPICAL RENAL CYSTIC LESIONS. Maria Cova
INTERDISCIPLINARY DISCUSSIONS IN LOCALISED RCC DIAGNOSIS AND SURGICAL STRATEGIES FOR ATYPICAL RENAL CYSTIC LESIONS Maria Cova Radiology Department University of Trieste (IT) Eleventh European International
More informationSerum Lipase Amylase Ratio in Predicting Aetiology, Severity and Outcome of Acute Pancreatitis in a Tertiary Care Hospital
Original Article Serum Lipase Amylase Ratio in Predicting Aetiology, Severity and Outcome of Acute Pancreatitis in a Tertiary Care Hospital Majharul Haque 1*, Golam Azam 2*, Debashis Kumar Sarkar 3, Anisur
More informationManagement of Acute Pancreatitis
Management of Acute Pancreatitis A Clinical Practice Guideline developed by the University of Toronto s Best Practice in Surgery JA Greenberg, M Bawazeer, J Hsu, J Marshall, JO Friedrich, A Nathens, N
More informationPrimary Pancreatic Lymphoma - CT Imaging Features and Differential Diagnosis
Primary Pancreatic Lymphoma - CT Imaging Features and Differential Diagnosis Poster No.: C-1644 Congress: ECR 2015 Type: Educational Exhibit Authors: A. T. Radu, M. C. Stefan, A.-M. Bratu, C. Zaharia;
More informationAbdominal Ultrasound
Abdominal Ultrasound What is Ultrasound Imaging of the Abdomen? What are some common uses of the procedure? How should I prepare? What does the equipment look like? How does the procedure work? How is
More informationMANAGEMENT RECOMMENDATIONS
1 MANAGEMENT RECOMMENDATIONS 1. Adrenal masses!!!!!!! page 2 2. Liver Masses!!!!!!! page 3 3. Obstetric US Soft Markers for Aneuploidy!! pages 4-6 4. Ovarian and Adnexal Cysts!!!!! pages 7-10 5. Pancreatic
More informationSudden death from retroperitoneal hemorrhage due to necrotizing pancreatitis
Asian Archives of Pathology 2014; Vol. 10 No.4, 117-121 Case report Sudden death from retroperitoneal hemorrhage due to necrotizing pancreatitis Kongtragoonmonkong O, Srisont S, Peonim V, Udnoon J Received
More informationNewcastle HPB MDM updated radiology imaging protocol recommendations. Author Dr John Scott. Consultant Radiologist Freeman Hospital
Newcastle HPB MDM updated radiology imaging protocol recommendations Author Dr John Scott. Consultant Radiologist Freeman Hospital This document is intended as a guide to aid radiologists and clinicians
More informationEndoscopic Ultrasonography Clinical Impact. Giancarlo Caletti. Gastroenterologia Università di Bologna. Caletti
Clinical Impact Giancarlo Gastroenterologia Università di Bologna AUSL di Imola,, Castel S. Pietro Terme (BO) 1982 Indications Diagnosis of Submucosal Tumors (SMT) Staging of Neoplasms Evaluation of Pancreato-Biliary
More informationNothing to declare. Probable causes for the change
acute pancreatitis March 25, 2017 C. S PITCHUMONI. MD,MACP,MACG,MPH.FRCP (c) Adjunct Professor of Medicine New York Medical College Professor of Medicine Rutgers university Nothing to declare Lesser sac?
More informationRole of imaging in RCC. Ultrasonography. Solid lesion. Cystic RCC. Solid RCC 31/08/60. From Diagnosis to Treatment: the Radiologist Perspective
Role of imaging in RCC From Diagnosis to Treatment: the Radiologist Perspective Diagnosis Staging Follow up Imaging modalities Limitations and pitfalls Duangkamon Prapruttam, MD Department of Therapeutic
More informationModified Computed Tomography Severity Index in Acute Pancreatitis - Its Correlation with Patient Morbidity (A Study of 40 Cases)
Original Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2018/138 Modified Computed Tomography Severity Index in Acute Pancreatitis - Its Correlation with Patient Morbidity (A Study
More informationCLINICAL MANIFESTATIONS AND DIAGNOSIS OF ACUTE PANCREATITIS. Raed Abu Sham a, M.D
CLINICAL MANIFESTATIONS AND DIAGNOSIS OF ACUTE PANCREATITIS Raed Abu Sham a, M.D ACUTE PANCREATITIS Acute inflammatory process of the pancreas that resolves both clinically and histologically. It is usually
More information