Acute pancreatitis: value and impact of CT severity index.
ABSTRACT Acute pancreatitis is a disease with a broad spectrum of findings that varies in severity from mild interstitial or edematous pancreas to severe forms with significant local and systemic complications that are associated with a substantial degree of morbidity and mortality. Several scoring systems are used to assess the severity and predict the outcome and prognosis of acute pancreatitis. These include the Ranson, Acute Physiology And Chronic Health Evaluation II (APACHE II) and Glasgow scales. The CT severity index (CTSI) derived by Balthazar et al. has become widely used for description of CT findings in acute pancreatitis. The purpose of this project was to examine the current best evidence about regarding the effect of using a CTSI on patient outcome and its value in comparison with other widely used scoring systems.
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- "The severity of abnormalities on an unenhanced CT is graded quantitatively and is combined with the severity of pancreatic necrosis on an enhanced CT to form the CT severity index (Table 2)  . This index has important prognostic implications, as described later . "
ABSTRACT: Acute pancreatitis is a relatively common disease that affects about 300,000 patients per annum in America with a mortality of about 7%. About 75% of pancreatitis is caused by gallstones or alcohol. Other important causes include hypertriglyceridemia, medication toxicity, trauma from endoscopic retrograde cholangiopancreatography, hypercalcemia, abdominal trauma, various infections, autoimmune, ischemia, and hereditary causes. In about 15% of cases the cause remains unknown after thorough investigation. This article discusses the causes, diagnosis, imaging findings, therapy, and complications of acute pancreatitis.Medical Clinics of North America 08/2008; 92(4):889-923, ix-x. DOI:10.1016/j.mcna.2008.04.013 · 2.61 Impact Factor
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- "Acute pancreatitis: assessment severity with Ranson score and CT evaluation [J]. J Med Assoc Thai, 2011, 94(4):437-40, APACHE II (Alhajeri and Erwin, 2008) and Balthazars CT score system etc. But the Ranson score system cannot be established without 48 h, examinations such as CT cannot be easily accomplished by bedside, APACHE II needed to be accomplished within 24 h, but there are so many indexes and it is very complicated to assess. "
ABSTRACT: To explore the risk factors and clinical significance of severe acute pancreatitis (SAP) complicated with acute cholecystitis (AC) in later stage. With case-control study method, collected clinical data of 42 cases of SAP complicated with AC patients (the experimental group) and 210 cases of SAP patients (the control group) from March, 2002 to March, 2011. Then used single factor non-conditional logistic regression method and multiple factors logistic regression method to screen the risk factors of SAP-AC. Single factors logistic regression showed that biliary lithiasis, Balthazars computed tomographic (CT) score, APACHE II score, local and systemic complication, somatostatin time, total parenteral nutrition (TPN) lasting time, glucocorticosteroid application, operation, etc, significantly affected SAP-AC. And multiple factors logistic regression showed that biliary lithiasis, APACHE II score, somatostatin application time, TPN lasting time and glucocorticosteroid application significantly affected SAP-AC. This study found that biliary lithiasis, APACHE II score, somatostatin time, TPN lasting time and glucocorticosteroid application were significant risk factors of SAP-AC. More attention should be paid on its predictive value; thus, the mortality and morbidity could be clinically reduced.
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ABSTRACT: This chapter reviews the clinical, macroscopic, and microscopic features, as well as the differential diagnosis of the most common pancreas lesions seen in a routine surgical pathology practice. It begins with the main congenital anomalies and metabolic disorders and then proceeds to the inflammatory conditions including acute and chronic pancreatitis and their subtypes. The neoplasia section begins with ductal neoplasia including the most common neoplasm of the pancreas, invasive ductal carcinoma, and other carcinomas of ductal origin. This is followed by a discussion of preinvasive ductal neoplasia and serous cystic neoplasms. The nonductal neoplasia section covers acinar cell carcinoma, endocrine neoplasia, solid pseudopapillary neoplasm, and pancreatoblastoma. Miscellaneous tumors and cystic lesions are also covered. Finally, quick review of how to report pancreatic tumors and the TNM classification of pancreatic tumors are presented.Gastroenterology 05/1962; 42:481-96. DOI:10.1007/978-1-4419-6043-6_43 · 16.72 Impact Factor