Abstract

Aims and Objectives:1.To identify the CT features of clinically suspected acute pancreatitis and grade the features according to modified CT severity index.2.to correlate the modified CT severity index with clinical outcome of patients.

Materials and Methods: Contrst enhanced CT scan was done in 50 patients referred from various clinical departments to the department of radio diagnosis, V S S Institute of Medical Science and Research, Burla. Study period was sept 2014 to sept 2016. CT features were scored according to modified CT severity index. Patients complications which were taken into consideration non the basis of duration of hospital stay, organ failure, surgical intervention, systemic infection and mortality.

Results and Conclusion: modified CT severity score was found to be significantly correlated with organ failure (p<0.002), systemic infection (p=0.001) and duration of hospital stay(p<0.01). The inclusion of extra pancreatic parenchymal complication in the modified CT severity scoring makes it a better prognostic indicator than CT severity scoring, used earlier ,for assessing adverse clinical outcomes in patients with acute pancreatitis.

Keywords: modified CT severity index ,acute pancreatitis, complications.

1.      Thomas L Bollen, Vikesh K Singh, Rie Maurer, Kathryn Repas, Hendrik W van Es, Peter A Banks and Koenraad J Mortele.  A Comparative Evaluation of Radiologic and Clinical Scoring Systems in the Early Prediction of Severity in Acute Pancreatitis. The American Journal of Gastroenterology 107, 612-619 (April 2012).

2.      Jauregui-Arrieta L, Alvarez-Lopez F, Cobian-Machuca H, Solis-Ugalde J, Torres- Mendoza B, Troyo-Sanroman R. Effectiveness of the modify tomographic severity index in patients with severe acutepancreatitis. Rev Gastroenterol Mex. 2008 Jul- Sep; 73(3):144-8

3.      Koenraad J. Mortele, Walter Wiesner, Lisa Intriere, Shridhar Shankar, Kelly H. Zou1, Babek N. Kalantari, Alex Perez, Eric van Sonnenberg, Pablo R. Ros, Peter A. Banks, Stuart G. Silverman: A Modified CT Severity Index for Evaluating Acute Pancreatitis: Improved Correlation with Patient Outcome, AJR: 2004, November.183.

4.      Thomas L. Bollen, Vikesh K. Singh, Rie Maurer, Kathryn Repas, Hendrik W. van Es, Peter A. Banks, Koenraad J. Mortele: Comparative Evaluation of the Modified CT Severity Index and CT Severity Index in Assessing Severity of Acute Pancreatitis, AJR: 2011 August, 197. Balthazar: CT diagnosis and staging of acute pancreatitis, RadiolClin. North America 27:19, 1989.

5.      Owen J. O’Connor, Sebastian McWilliams, Michael M. Maher: Imaging of Acute Pancreatitis, 1Department of Radiology, Cork University Hospital, University College Cork, Wilton, Cork, Ireland. AJR: 2011 August, 197

6.      B C Koo, A Chinogureyi, and A S Shaw: Imaging acute pancreatitis, The British Journal of Radiology. 2010;83:104–112.

7.      B U Wu, R S Johannes, X Sun, Y Tabak, D L Conwell, P A Banks The early prediction of mortality in acute pancreatitis: a large population-based study Gut. 2008;57:1698–1703. doi:10.1136/gut.2008.152702

8.      MarshallJC,CookDJ,ChristouNV,etal:Multipleorgan dysfunction score: An reliable descriptor of a complex clinical outcome. CritCareMed 1995;23:1638-52.

9.      Balthazar E J, Freeny PC, Van Sonneberg E Imaging and intervention in acute pancreatitis. Radiology. 1994;193;23: 898-905.

10.  John  Treacy,  Anthony  Williams,  Renz  Bais,     Krysten Willson,  Christopher Worthley, John Reece, Justin Bessell, David Thomas. Evaluation of amylase and lipase in the diagnosis of acute pancreatitis. ANZ Journal of Surgery, 2001, Volume 71, Issue 10,577–58.

11.  Bradley 3rd EL. A clinically based classification system for acute pancreatitis. Arch Surg 1993; 128:586.