Assessment of Pancreatitis Complications by Multidetector CT: Review

Abstract

Acute pancreatitis is a frequent disease characterized by sudden upper abdominal pain andvomiting in the emergency setting. Alcoholism and choledocholithiasis are the most commonetiological factors. Presentation ranges from a mild-self limiting condition to one with significantmorbidity and mortality in its most severe forms. Contrast-enhanced CT has a significant rolein evaluating the extent and evolution of the disease and its associated complications. Thepurpose of this article is to summarize pancreatic complications along with contrast-enhancedCT images

Keywords

• Pancreatitis,Complications,Multidetector CT

PANKREATİT KOMPLİKASYONLARININ MULTİDEDEKTÖR BT İLE DEĞERLENDİRİLMESİ: DERLEME

Abstract

Akut pankreatit, acil ortamda akut üst karın ağrısı ve kusma ile karakterize sık bir hastalıktır.Alkolizm ve koledokolitiazis en sık etyolojik faktörlerdir. Prezentasyonu hafif-kendi kendinisınırlayan durumdan, en şiddetli formunda önemli morbidite ve mortalite olan duruma kadardeğişir. Kontrastlı BT hastalığın gelişimi, uzanımı ve ilişkili komplikasyonlarındeğerlendirilmesinde önemli bir role sahiptir. Bu makalenin amacı, kontrastlı BT görüntülerieşliğinde pankreatik komplikasyonları özetlemektir

Keywords

• Pankreatit,Komplikasyon,Multidedektör BT

References

1. Roberts SE, Williams JG, Meddings D, et al. Incidence and case fatality for acute pancreatitis in England: geographical variation, social deprivation, alcohol consumption and aetiologyea record linkage study. Aliment Pharmacol Ther. 2008;28:931-41.
2. Gurusamy KS, Farouk M, Tweedie JH. UK guidelines for management of acute pancreatitis: is it time to change? Gut. 2005;54:1344-5.
3. Balthazar EJ, Freeny PC, van Sonnenberg E. Imaging and in- tervention in acute pancreatitis. Radiology. 1994;193:297-306.
4. Lenhart DK, Balthazar EJ. MDCT of acute mild (nonnec- rotizing) pancreatitis: abdominal complications and fate of fluid collections. AJR. 2008;190:643-649.
5. Whitcomb DC. Clinical practice. Acute pancreatitis. N Engl J Med. 2006;354:2142-50.
6. Bradley III EL. A clinically based classification system for acute pancre-atitis. Summary of the international symposium on acute pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg. 1993;128:586-90.
7. Acute Pancreatitis Classification Working Group. Revision of the Atlanta classification of acute pancreatitis,http: // www. pancreasclub. com / resources / Atlanta Classification. pdf (9- 4-2008) [Accessed March 2010].
8. Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174:331-6.

9. Shankar S, vanSonnenberg E, Silverman SG, et al. Imaging and percutaneous management of acute complicated pancreatitis. Cardiovasc Intervent Radiol. 2004;27:567-80.
10. Larvin M, Chalmers AG, McMahon MJ. Dynamic contrast enhanced computed tomography: a precise technique for identifying and local-ising pancreatic necrosis. BMJ. 1990;300:1425-8.
11. Johnson CD, Stephens DH, Sarr MG. CT of acute pancreatitis: correlation between lack of contrast enhancement and pancreatic necrosis. AJR. 1991;156:93-5.
12. Isenmann R, Buchler M, Uhl W, et al. Pancreatic necrosis: an early finding in severe acute pancreatitis. Pancreas. 1993;8:358-61.
13. Johnson CD, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 2004;53:1340-4.
14. Mitchell RM, Byrne MF, Baillie J. Pancreatitis. Lancet. 2003;361:1447-55.
15. Papachristou GI, Clermont G, Sharma A, et al. Risk and markers of severe acute pancreatitis. Gastroenterol Clin North Am. 2007;36:277-96.
16. Buter A, Imrie CW, Carter CR, et al. Dynamic nature of early organ dysfunction determines outcome in acute pancreatitis. Br J Surg 2002;89:298-302.
17. Papachristou GI, Whitcomb DC. Predictors of severity and necrosis in acute pancreatitis. Gastroenterol Clin North Am. 2004;33:871-90. .
18. Marshall JC, Cook DJ, Christou NV, et al. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Crit Care Med. 1995;23:1638-52.
19. Vincent JL,MorenoR, Takala J, et al. The SOFA (Sepsis- related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis- related problems of the European society of intensive care medicine. Intensive Care Med. 1996;22:707-10.
20. De Campos T, Cerqueira C, Kuryura L, et al. Morbimortality indicators in severe acute pancreatitis. JOP. 2008;9:690-7.
21. Ranson JH, Rifkind KM, Roses DF, et al. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139:69-81.
22. Balthazar EJ, Ranson JH, Naidich DP, et al. Acute pancreatitis: prognostic value of CT. Radiology. 1985;156:767-72.
23. Mortele KJ, Wiesner W, Intriere L, et al. A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. AJR. 2004;183:1261-5.
24. Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. Am J Gastroenterol. 2006;101:2379-400.
25. Rickes S, Monkemuller K, Malfertheiner P. Acute severe pancreatitis: contrast-enhanced sonography. Abdom Imaging. 2007;32:362-4.
26. Kim DH, Pickhardt PJ. Radiologic assessment of acute and chronic pancreatitis. Surg Clin North Am. 2007;87:1341-58.
27. Maher MM, Lucey BC, Gervais DA, Mueller PR. Acute pancreatitis: the role of imaging and interventional radiology. Cardiovasc Intervent Radiol. 2004; 27:208–225
28. Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation.Radiology. 2002;223:603-13.
29. Delrue LJ, De Waele JJ, Duyck PO. Acute pancreatitis: radiologic scores in predicting severity and outcome. Abdom Imaging. 2010;35:349-61.
30. Takahashi N, Papachristou GI, Schmit GD, et al. CT findings of walled-off pancreatic necrosis (WOPN): differentiation from pseudocyst and prediction of outcome after endoscopic therapy. Eur Radiol. 2008;18:2522-9.
31. Bharwani N, Patel S, Prabhudesai S, Fotheringham T, Power N. Acute pancreatitis: the role of imaging in diagnosis and management. Clin Radiol. 2011;66:164-75.
32. Merkle EM, Gorich J. Imaging of acute pancreatitis. Eur Radiol. 2002;12:1979-92.
33. Scaglione M, Casciani E, Pinto A, et al. Imaging assessment of acute pancreatitis: a review. Semin Ultrasound CT MR. 2008;29:322-40.
34. Bernades P, Baetz A, Levy P, et al. Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical-surgical series of 266 patients. Dig Dis Sci. 1992;37:340-6.
35. Mortele KJ, Mergo PJ, Taylor HM, et al. Peripancreatic vascular abnormalities complicating acute pancreatitis: contrast-enhanced helical CT findings. Eur J Radiol. 2004;52:67-72.
36. Boudghene F, L’Hermine C, Bigot JM. Arterial complications of pancre-atitis: diagnostic and therapeutic aspects in 104 cases. J Vasc Interv Radiol. 1993;4:551-8.
37. Kirby JM, Vora P, Midia M, et al. Vascular complications of pancreatitis: imaging and intervention. Cardiovasc Intervent Radiol. 2008;31:957-70.
38. Mallick IH, Winslet MC. Vascular complications of pancreatitis. JOP. 2004;5:328-37.