title: Analysis of the power of common diagnostic tools in the management of acute pancreatitis.
abstract: Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases. 69 out of 283 patients (24,3%) had CRP >150 mg/dl within 48 hours after admission. 32 of them had SAP. The CRP cutoff of 150 mg/L had a sensitivity of 80% and a specificity of 65%. The positive predictive value for SAP in patients beyond the cutoff is 46.4%. The negative predictive value for SAP in patients below the cutoff was 89.5%. Our results support the opinion that an early CE-CT is usually not indicated. CRP helps to assess the course of AP; levels below 150 mg/dl between the first 48 h indicate a mild course in most of the cases.
authors.affiliation: Sozialstiftung Bamberg-Medizinische Klinik II, 96049 Bamberg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Nistal
authors.affiliation: Medizinische Klinik I, Universitaetsklinikum Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Malalai
authors.initials: M
authors.lastname: Zoltani
authors.affiliation: Medizinische Klinik I, Universitaetsklinikum Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors.forename: Ansgar W
authors.initials: AW
authors.lastname: Lohse
authors.affiliation: Department of Internal Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Daniele
authors.affiliation: Department of Internal Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.
authors.forename: Manfredi
authors.identifier: 0000-0002-3967-1552
authors.initials: M
authors.lastname: Tesauro
authors.affiliation: Medizinische Klinik I, Universitaetsklinikum Hamburg-Eppendorf, 20246 Hamburg, Germany ; Klinik für Gastroenterologie, Friedrich-Ebert-Krankenhaus, 24534 Neumünster, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pace