Evaluation of the Role of Computer Tomography Imaging Findings in Determining the Prognosis in Acute Pancreatitis Case by Comparison with Ranson Criteria

Abstract

Background/Purpose:
 Acute pancreatitis (AP) progresses with pathological changes. Therefore, the prognosis of the disease can be quite variable. In severe pancreatitis, local or systemic complications with high mortality may occur. Treatment of patients after diagnosis of AP depends on early assessment of disease severity. In this study, we aimed to evaluate the effectiveness of predicting pancreatitis severity and prognosis by comparing computerized tomography (CT) scan findings with Ranson criteria.
 Methods:
 Patients aged 18 years and over who applied to our hospital with the diagnosis of AP between January 2018 and December 2020 were included in the study. We retrospectively analyzed 190 patients in order to determine the severity and prognosis of pancreatitis by comparing CT scan findings and Ranson criteria. Demographic, clinical, radiological and laboratory data of the patients at the time of admission were retrospectively analyzed. In laboratory data, hematocrit (HTC) decrease, blood urea nitrogen (BUN) increase, serum calcium (Ca) level, partial arterial oxygen pressure (PaO2), base deficit and fluid sequestration were evaluated. On CT findings, pancreatic expansion, pancreatic density, peripancreatic fluid collection, intra-abdominal ascites, peripancreatic fatty tissue heterogeneity, presence of peripancreatic lymph nodes, Wirsung duct diameter, presence of pathology in the gallbladder, hepatosteatosis, splenomegaly, splenic vein diameter were assessed.
 Results: 
 A statistically significant difference was found in the comparison of the degree of peripancreatic fluid collection and the severity of pancreatitis. There was no statistically significant difference in our other comparisons. 
 Conclusion: 
 In general, studies are dominated by the opinion that the presence of necrosis in patients with AP may be a criterion for determining the prognosis. In our study, it was determined that the presence or absence of pancreatic necrosis in the CT performed at the time of admission was not a prognostic predictor. However, follow-up of necrosis in control imaging can be a marker in determining the prognosis.