2018 Month : July Volume : 5 Issue : 28 Page : 2105-2109
Brajendra Nath Tripathi1, Rajeev Sethi2, Sandhya Pandey3
Dr. Sandhya Pandey,
Arvind Imaging Centre,
This study emphasizes the importance of computed tomography (CT) imaging in acute pancreatitis to grade clinical severity and predict outcome. The clinical and radiological findings in acute pancreatitis were correlated to predict the severity of the disease and its prognosis.
MATERIALS AND METHODS
Selected patients with clinical diagnosis of acute pancreatitis were evaluated clinically using Ranson’s criteria and then by CT scan for Balthazar grading and CT severity index (CTSI).
In our prospective study of 91 patients of acute pancreatitis, the male:female ratio was approximately 2:1 and the aetiological agents were mainly alcoholism (41) seen predominantly in males and cholelithiasis (32) which was more in females. The Ranson’s score of acute pancreatitis was calculated based on appropriate laboratory data and divided into two groups - mild in 51 and severe in 40 patients. The findings on CT scan were taken as standard for classifying acute pancreatitis into mild (57) and severe (34) forms based on Balthazar CTSI. 5 patients with severe form had prolonged hospital stay (>20 days). Also 5 patients had expired during the study duration (5.5 %) and they had severe form. The sensitivity and specificity of Ranson’s criteria to correctly prognosticate the severity of acute pancreatitis were 86% and 68% respectively on correlation with Balthazar’s CTSI. The discrepancy between Ranson’s and Balthazar’s CTSI in assessing the severity of acute pancreatitis existed in approximately 22% of the cases.
The Balthazar’s CTSI based classification is superior to Ranson’s scoring system in prediction and prognostication of severity of acute pancreatitis as computed tomography study provides direct visualization of anatomical distortion and pathological extension of disease process in acute pancreatitis, with particular emphasis on pancreatic necrosis.
Acute pancreatitis, computed tomography, necrosis, severity index, prognosis.