Modified CT severity index for evaluation of acute pancreatitis and correlation with patient outcome

2020 ◽  
Vol 13 (3) ◽  
pp. 154-161
Author(s):  
Polysetty Obuleswar Prasad ◽  
◽  
N S Vidya ◽  
G V. Prasad ◽  
D R Anand ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Acute Pancreatitis ◽  
Severity Index

A MODIFIED CT SEVERITY INDEX FOR EVALUATING ACUTE PANCREATITIS: IMPROVED CORRELATION WITH PATIENT OUTCOME.

Pancreas ◽  
2004 ◽  
Vol 29 (4) ◽  
pp. 363
Author(s):  
K.J. Mortele ◽  
K.H. Zou ◽  
P.A. Banks ◽  
S.G. Silverman
Keyword(s):  
Patient Outcome ◽  
Acute Pancreatitis ◽  
Severity Index

Clinical Profile and Outcomes in Patients with Acute Pancreatitis attending a Teaching Hospital at Gandaki Province, Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Subash Bhattarai ◽  
Merina Gyawali
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Age Groups ◽  
Data Entry ◽  
Kidney Injury ◽  
Severity Index ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Systemic Complications ◽  
Keywords Alcohol

Background: Acute pancreatitis (AP) is inflammatory process of pancreas presenting with acute abdominal pain.The majority of patients have mild disease. Some patients develop local and systemic complications with increased morbidity and mortality. This study was undertaken to describe the clinical profile and outcomes in patients with acute pancreatitis.   Methods:  A cross-sectional hospital based study comprising of 62 consecutive patients with acute pancreatitis were enrolled between Jan 2019 to August 2020. Clinical profile at admission, complications and clinical outcomes including mortality were studied. Patients were classified into mild, moderately severe and severe acute pancreatitis based on revised Atlanta classification and modified CT severity index.  Data entry was done in Statistical Packages for the Social Sciences version 20. Results: The mean age of study subjects was 44±10.87 years with 43 (56%) males and 19 (44%) females (M:F=2.1:1). The commonest etiology of pancreatitis was alcohol (53.2%) followed by biliary pancreatitis (37.1%)  The most common presentation was abdominal pain (100%). The most common complication was pancreatic necrosis (21%) followed by acute kidney injury (19.4%) and pleural effusion (17.3%). Majority( 72.6%) was mild and 17.7% had severe acute pancreatitis. Mortality was seen in 6.5% patients. Mortality was observed in patients with persistent complications, organ failure, low serum calcium and high modified CT severity index.   Conclusions: Alcohol and gallstones were the two main etiologies of acute pancreatitis and were common in males, and in middle age groups. Majority presented with mild severity. Mortality was observed in some patients with severe acute pancreatitis.   Keywords: alcohol; biliary; CT severity index; mortality; outcome; pancreatitis          

scholarly journals Confocal laser endomicroscopy reveals alterations in duodenal permeability in patients with acute pancreatitis

2019 ◽  
Vol 47 (3) ◽  
pp. 1279-1287
Author(s):  
Lingjia Sun ◽  
Min Yue ◽  
Yining Dai ◽  
Chaohui Yu ◽  
Chunxiao Chen
Keyword(s):  
Acute Pancreatitis ◽  
Large Scale ◽  
Duodenal Bulb ◽  
Severity Index ◽  
Duodenal Mucosa ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Mucosal Permeability ◽  
Reactive Protein ◽  
Severity Index Score

Objective Intestinal permeability increases during the course of acute pancreatitis (AP). We assessed duodenal permeability alterations in patients with AP by confocal laser endomicroscopy (CLE). Methods Thirty patients with AP underwent CLE evaluation of the antral and duodenal mucosa. Images were graded based on the appearance of capillaries and the degree of fluorescein leakage. Results Patients with AP had increased duodenal mucosal permeability that could be detected by CLE. The mucosal permeability progressively increased in the gastric antrum, duodenal bulb, and descending duodenum. The CLE parameters in the antrum and duodenal bulb were not significantly different between patients with mild and severe AP. The CLE grades in the descending duodenum were higher in patients with severe than mild AP. The C-reactive protein level in AP was positively correlated with the permeability in the duodenal bulb and descending duodenum, while the computed tomography severity index score was positively correlated with the mucosal permeability in the duodenal bulb and descending duodenum. Conclusion CLE revealed increased duodenal permeability in patients with AP. Higher permeability in the descending duodenum was observed in severe than mild AP. Further large-scale studies are needed to confirm the relationship between altered duodenal permeability and the severity of AP.

Advantages of Modified Computed Tomography Severity Index of Acute Pancreatitis Over Other Scoring System

KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
Md Mofazzal Sharif ◽  
Khaleda Parvin Rekha ◽  
Umme Iffat Siddiqua ◽  
Mst Monira Khatun ◽  
AKM Enamul Haque ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Clinical Outcome ◽  
Severe Disease ◽  
Severity Index ◽  
Observer Variation ◽  
Imaging Method ◽  
Close Monitoring ◽  
Early Assessment ◽  
Prompt Treatment

Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal Computed Tomography (CT) are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagnosing as well as demonstrating the extent. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease. CT is the imaging method of choice for assessing the extent of acute pancreatitis and for evaluating complications. CT severity index is used to assess prognostic correlation and clinical outcome of acute pancreatitis. Modified CT severity index makes the score easier to calculate and reduces the inter-observer variation. KYAMC Journal Vol. 10, No.-2, July 2019, Page 110-113

Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

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