Reporting of acute pancreatitis by radiologists-time for a systematic change with structured reporting template

Khurana, Aman; Nelson, Leslie W.; Myers, Christopher G.; Akisik, Fatih; Jeffrey, Brooke R.; Miller, Frank H.; Mittal, Pardeep; Morgan, Desiree E.; Mortelé, Koenraad J.; Poullos, Peter D.; Sahani, Dushyant V.; Sandrasegaran, Kumar; Tirkes, Temel; Zaheer, Atif; Patel, Bhavik N.

doi:10.1007/s00261-020-02468-9

Cited by 17 publications

(15 citation statements)

References 45 publications

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“…IEP is more common, accounting for about 85% of fluid collections in patients with acute pancreatitis 15. Complications associated with IEP include acute peripancreatic fluid collections or chronic pancreatic pseudocyst.…”

Section: Presentation and Diagnosismentioning

confidence: 99%

Managing severe acute and necrotizing pancreatitis

Wieren¹,

Guild²,

Raucci³

et al. 2022

Jaapa

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2002 to 2005. 4 Gallstone-related disorders may be the cause of this increase in the United States, because of increases in obesity and the aging population, although it also may be related to an increased frequency of testing (Figure 1). 4 This comes at a huge cost to the healthcare system, with more than $2.4 billion spent per year in the United States alone. 5 Management of acute pancreatitis has changed considerably in the past 10 years, including a multidisciplinary methodology, and tailored interventions with a minimally invasive endoscopic approach rather than open surgical intervention for complications. 6 To reduce patient morbidity and mortality, clinicians must be familiar with the presentation, diagnosis, and management of this disease.© MEDICALSTOCKS/SHUTTERSTOCK.COM I n most patients, acute pancreatitis is mild, self-limited, and follows an uncomplicated course. 1 However, 15% to 20% of all patients have severe acute pancreatitis, and 5% to 10% of them will develop necrosis of the pancreatic glands, peripancreatic tissue, or both. 2 In severe cases, if the necrotic collection becomes infected, patient mortality can reach 30%. 3 The incidence of acute pancreatitis requiring hospitalization in the United States continues to rise, with a 13.2% increase between 2009 and 2012 compared with ABSTRACT Acute pancreatitis is associated with signifi cant morbidity and mortality, and is one of the most common gastrointestinal disorders requiring hospitalization. This article describes current concepts in the diagnosis and management of severe acute and necrotizing pancreatitis. Management of this disease requires IV fl uids, pain control, and advanced medical and interventional care. Early identifi cation and intervention may help to prevent patient morbidity and mortality.

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Section: Presentation and Diagnosismentioning

confidence: 99%

Managing severe acute and necrotizing pancreatitis

Wieren¹,

Guild²,

Raucci³

et al. 2022

Jaapa

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“…Based on the distribution and location of necrosis, NP can be further subdivided into three subtypes ( 46 ): (1) combined pancreatic and peripancreatic necrosis (about 75.0%); (2) peripancreatic necrosis only (about 20.0%); and (3) pancreatic necrosis only (about 5.0%). The literature indicates that compared with NP, the mortality rate of IEP is about 3.0% while the mortality rate of NP is about 17%; and if combined with infection, the mortality rate of NP can rise to about 30% ( 46 , 51 ). Consequently, it is of great clinical significance to distinguish IEP from NP for predicting the prognosis of AP patients.…”

Section: Clinical Applicationsmentioning

confidence: 99%

“…Consequently, it is of great clinical significance to distinguish IEP from NP for predicting the prognosis of AP patients. In the international structured reporting template of AP based on CECT published in 2020, experts also highlighted the importance of radiologists to clarify the morphologic subtypes of AP, the degree and anatomic area involvement of NP, the type and location of peripancreatic collections, and some other key points in the CT reports ( 51 ).…”

Section: Clinical Applicationsmentioning

confidence: 99%

Radiomics and Its Applications and Progress in Pancreatitis: A Current State of the Art Review

Yan

Gaowen²,

et al. 2022

Front. Med.

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Radiomics involves high-throughput extraction and analysis of quantitative information from medical images. Since it was proposed in 2012, there are some publications on the application of radiomics for (1) predicting recurrent acute pancreatitis (RAP), clinical severity of acute pancreatitis (AP), and extrapancreatic necrosis in AP; (2) differentiating mass-forming chronic pancreatitis (MFCP) from pancreatic ductal adenocarcinoma (PDAC), focal autoimmune pancreatitis (AIP) from PDAC, and functional abdominal pain (functional gastrointestinal diseases) from RAP and chronic pancreatitis (CP); and (3) identifying CP and normal pancreas, and CP risk factors and complications. In this review, we aim to systematically summarize the applications and progress of radiomics in pancreatitis and it associated situations, so as to provide reference for related research.

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“…It detects early complications like inflamed peripancreatic planes with retroperitoneal fluid collections during the patient's initial hospital stay. Long-term follow-up imaging of these patients on an outpatient basis might be required to exclude late complications of SAP, including disconnected duct syndrome and pancreatico-cutaneous fistula formation 8 .…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of computed tomography scoring index in predicting mortality among suspected patients of acute pancreatitis

Omair

Azmat²,

Rakhshani³

2021

Int. j. endorsing health sci. res.

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Background: Acute pancreatitis (AP) is challenging, varying from subtle edema to parenchymal necrosis in severity. Several clinical and radiological scoring criteria have been formulated over the years to predict the disease intensity of AP to guide monitoring and intervention. This study aimed to establish the diagnostic accuracy of high Balthazar’s computed tomography scoring index (CTSI) in predicting outcomes in terms of mortality and morbidity among suspected cases of the acutely inflamed pancreas. Methodology: A cross-sectional study was carried out at the Radiology Department of Jinnah Postgraduate Medical Center (JPMC), Karachi. A total of 1434 clinically suspected AP patients were included in this study. The initial diagnosis was made through contrast-enhanced computed tomography (CECT) of the abdomen. Balthazar's CTSI ascertained the disease severity, and outcomes were recorded in terms of survival and death. Results: The gender distribution showed a male majority, i.e. 789(55%), and most patients were in the 45-55 year age group comprising 650 patients (45.3%). Moreover, out of 1434 patients, 397(28%) died while the rest survived. This study showed that high CTSI is a prognostic indicator of mortality in suspected cases of AP. It has a sensitivity of 91.9%, specificity of 88.72%, a positive predictive value (PPV) of 94.5% and a negative predictive value (NPV) of 83.98%. Overall diagnostic accuracy (DA) was found to be 90.9%. Conclusion: It is concluded from the study results that Balthazar’s CT severity index is reliable in establishing severity and disease outcome in AP. Thus, its routine application should be encouraged for timely detection and appropriate management of AP.

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Reporting of acute pancreatitis by radiologists-time for a systematic change with structured reporting template

Cited by 17 publications

References 45 publications

Managing severe acute and necrotizing pancreatitis

Managing severe acute and necrotizing pancreatitis

Radiomics and Its Applications and Progress in Pancreatitis: A Current State of the Art Review

Diagnostic accuracy of computed tomography scoring index in predicting mortality among suspected patients of acute pancreatitis

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