Acute pancreatitis: assessment of severity with clinical and CT evaluation.
Treatment of patients with acute pancreatitis is based on the initial assessment of disease severity. Severe pancreatitis occurs in 20%-30% of all patients with acute pancreatitis and is characterized by a protracted clinical course, multiorgan failure, and pancreatic necrosis. Early staging is based on the presence and degree of systemic failure (cardiovascular, pulmonary, renal) and on the presence and extent of pancreatic necrosis. Individual laboratory indexes (markers of pancreatic injury, markers of inflammatory response), while promising, have not yet gained clinical acceptance. Numeric grading systems with sensitivities of about 70% are commonly used today as indicators of organ failure and disease severity. Contrast material-enhanced computed tomography is used in addition to help evaluate local pancreatic morphology and the presence and extent of pancreatic necrosis. Advantages and limitations of the clinical, laboratory, and imaging prognostic indexes are analyzed and discussed.
Balthazar
Emil J
EJ
Department of Radiology, New Bellevue Hospital, 462 First Ave, 3rd Fl, Rm 3W37-3W42, New York, NY 10016, USA. emiljmd@aol.com
D000208:Acute Disease; D003287:Contrast Media; D006801:Humans; D009336:Necrosis; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011379:Prognosis; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D003287:Contrast Media