Journal ArticleDOI
Acute pancreatitis: value of CT in establishing prognosis.
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TLDR
A CT severity index, based on a combination of peripancreatic inflammation, phlegmon, and degree of pancreatic necrosis as seen at initial CT study, was developed and showed clear trends in patients who initially had or developed more than 30% necrosis.Abstract:
The presence and degree of pancreatic necrosis (30%, 50%, or greater than 50%) was evaluated by means of bolus injection of contrast material and dynamic sequential computed tomography (CT) in 88 patients with acute pancreatitis at initial and follow-up examinations. Pancreatic necrosis was defined as lack of enhancement of all or a portion of the gland. Length of hospitalization, morbidity, and mortality in patients with early or late necrosis (22 patients) were evaluated and compared with the same criteria in the rest of the group. Patients with necrosis had a 23% mortality and an 82% complication rate; patients without necrosis had 0% mortality and 6% morbidity. When only the initial assessment was considered, patients with peripancreatic phlegmons and necrosis had 80% morbidity, compared with 36% morbidity in those with phlegmons and no necrosis. Serious complications occurred in patients who initially had or developed more than 30% necrosis. A CT severity index, based on a combination of peripancreatic inflammation, phlegmon, and degree of pancreatic necrosis as seen at initial CT study, was developed. Patients with a high CT severity index had 92% morbidity and 17% mortality; patients with a low CT severity index had 2% morbidity, and none died.read more
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Riktlinjer för handläggning av patienter med akut pankreatit.
Ingemar Ihse,Roland Andersson,Jonas Blind,Anders Borgström,Thomas Gasslander,Ulf Haglund,Bengt Åke Henriksson,Anders Hyltander,Jörgen Larsson,C. Lundstedt,Johan Permert,Joar Svanvik +11 more
TL;DR: National guidelines for management of acute pancreatitis are offered for treatment of mild and severe pancreatitis, as well as for the management of pseudocysts and attention is paid to diagnosis, severity assessment and etiology.
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Labeled granulocyte scanning for the diagnosis of infected necrosis in acute pancreatitis: what kind of labeling should be used?
D. Heresbach,A. Devillers,Rabot A,A. Moisan,Y. Mallédant,Bourguet P,J. F. Bretagne,Gosselin M +7 more
TL;DR: Labeled granulocyte scintigraphy was shown to be an effective tool for the diagnosis of infection in pancreatic and/or peripancreatic necrosis due to acute pancreatitis, especially when the scintiscans are performed early after injection of 99Tcm or when the fall in splenic activity over the 24 h following reinjection of 111In is measured in particularly difficult cases.
Journal ArticleDOI
Recent Advances in Diagnosis and Severity Assessment of Acute Pancreatitis
TL;DR: A comprehensive review of recent advances in diagnosis and severity assessment of acute pancreatitis has been described.
Journal ArticleDOI
99mTc-hexamethylpropylene amineoxime leukocyte scintigraphy in acute pancreatitis: an alternative to contrast-enhanced computed tomography?
Eduardo Moreno-Osset,Antonio López,Leticia de la Cueva,María Jesús Martínez,Fernando Gómez,Vicente Alfonso,Tomás Ripollés,R. Sopena +7 more
TL;DR: Results show that leukocytes are related to the severity of local pancreatic damage in AP, and LLS is a potential alternative technique to CECT for staging AP.
Journal ArticleDOI
Endoscopic treatment with transmural drainage and necrosectomy for walled-off necrosis provides favourable long-term outcomes on pancreatic function.
Andreas Bartholdy,Mikkel Werge,Srdan Novovic,Amer Hadi,Camilla Nøjgaard,Anders Borch,Erik Feldager,Lise Lotte Gluud,Palle Nordblad Schmidt +8 more
TL;DR: The favourable outcomes on survival, pancreatic function and social status support current recommendations of endoscopic transmural drainage and necrosectomy being the treatment of choice for walled-off pancreatic necrosis.
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