A Study on Comparitive Role of Ultrasonogram and Computed Tomography in Diagnosis of Acute Pancreatitis

Abstract

Acute pancreatitis is an acute inflammatory disease of the pancreas characterized by auto digestion of pancreatic parenchyma, resulting from the inappropriate intracellular activity of proteolytic pancreatic enzymes. Radiological imaging is crucial in making a decision in management of patients with acute pancreatitis. The present study was aimed to study the role of ultrasonography and computed tomography in various cases of acute pancreatitis and to note the advantages of one imaging modality over the other. Material and Methods: A two year prospective study was conducted at a tertiary care hospital after approval from ethical committee. Cases of acute pancreatitis were enrolled and socio demographic data, clinical history were noted and Ultrasonogram and Computed tomography was performed. Plain radiographs, biochemical investigations were correlated with the USG and CT findings. The collected data was entered in a Microsoft excel spread sheet and analyzed. Mean, median was calculated for constant variables. Results: 100 cases were enrolled in study with 82 males and 18 females. 31-40 years was the common age group and the mean age of cases was 36.12± 1.8 years. Alcoholism was commonest etiology (68%) and epigastric pain was the common symptom.82% of cases was diagnosed by ultra sonogram whereas 100% of cases were diagnosed by CT. 18 cases were not diagnosed on USG due to bowel inflation. 52 of the cases (63.4%) demonstrated heterogeneous hypoechoic echotexture with areas of calcification in 24 cases and 12 cases (14.63%) homogenous hypoechoic echotexture. Conclusion: To conclude, the overall visualization of the pancreas was far better by CT than by ultrasound. Alterations in size were better appreciated on CT. Ultrasound proved more useful in detecting free fluid. The positive predictive value of both ultrasound and CT was 100%. This means that all patients with a bulky, hypoechoic pancreas on ultrasound have acute pancreatitis. Our study suggest that, a negative ultrasound study does not exclude significant and, at times, life-threatening pancreatic disease.

Comparison of Magnetic Resonance Cholangiopancreatography (MRCP) with Ultrasonography (USG) and Computed Tomography (CT) in the Evaluation of Patients with Obstructive Jaundice

“…Also ERCP correlation, if available would have given a complete analysis of all the diagnostic modalities of obstructive jaundice. [19][20][21][22][23]…”