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Role of multi-detector computed tomography in severity assessment of cases of acute pancreatitis

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Summary

Background

The mortality and morbidity of acute pancreatitis is high, especially in the severe variant. The present study was performed to study the role of multi-detector computed tomography (MDCT) in grading the severity of acute pancreatitis and to compare the scoring system with the revised Atlanta classification (RAC) and with the outcomes of acute pancreatitis.

Material and methods

A single-centre cross-sectional observational study was conducted between November 2017 and March 2019 with a sample size of 152 patients. Patients underwent a 128-slice contrast-enhanced CT (CECT) of the whole abdomen. Sequential organ failure assessment (SOFA) scores were calculated for all cases. Patients were followed until discharge or death and the outcomes such as hospital stay, intensive care unit (ICU) stay, evidence of organ failure, infection, need for intervention and death were tested with the modified computed tomography severity index (MCTSI) and RAC.

Results

Males constituted the majority of the study population (2.4:1). As per MCTSI, 25 patients (16.5%) had mild pancreatitis, 49 (32.2%) had moderately severe pancreatitis and 78 (51.3%) had severe acute pancreatitis. There was a good concordance between MCTSI and RAC. There was a statistically significant association of MCTSI and RAC with hospital stay, need for ICU stay, organ failure and requirement for intervention; however, there was no statistically significant association with infectious complications and mortality.

Conclusion

The MDCT is a very useful investigation in the diagnosis and management of acute pancreatitis. The threshold to opt for MDCT imaging in acute pancreatitis should be low for performing the timely interventions required in acute pancreatitis.

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Authors and Affiliations

  1. Department of Radiodiagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, 110001, New Delhi, India

    PS Saneesh & UC Garga

  2. Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, 110001, New Delhi, India

    Arun Kumar Gupta &  Raghav Yelamanchi

Authors
  1. PS Saneesh
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  2. UC Garga
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  3. Arun Kumar Gupta
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  4. Raghav Yelamanchi
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Saneesh PS, UC Garga, Arun Kumar Gupta and Raghav Yelamanchi. The first draft of the manuscript was written by Raghav Yelamanchi and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Raghav Yelamanchi.

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Conflict of interest

PS. Saneesh, UC. Garga, A.K. Gupta and R. Yelamanchi declare that they have no competing interests.

Ethical standards

This study was performed in line with the principles of the Declaration of Helsinki 1964 revised in 2013. Approval was granted by the ethics committee of PGIMER/RMLH. Consent was taken for participation from all participants. Consent for publication of results and data was taken from all participants.

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Saneesh, P., Garga, U., Gupta, A.K. et al. Role of multi-detector computed tomography in severity assessment of cases of acute pancreatitis. Wien Klin Wochenschr 133, 654–660 (2021). https://doi.org/10.1007/s00508-021-01870-7

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  • DOI: https://doi.org/10.1007/s00508-021-01870-7

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