Contrast-enhanced Computed Tomographic Evaluation of Acute Pancreatitis: An Exploratory Study

Introduction: Diseases of the pancreas have a very variable presentation and hence imaging plays an important role in the diagnosis and management of pancreatic disease, especially in acute pancreatitis. Computed tomography (CT) is the modality of choice as an evaluation of the pancreas. Materials and Methods: A total of 30 patients who were clinically suspected of having acute pancreatitis attending our hospital were our study participants. Results: The present study consisted of 30 patients who were suspected to have acute pancreatitis by clinical examination and laboratory parameters and referred for contrast-enhanced CT (CECT) examination of the abdomen. The peak age of incidence was noted in 30-40 years. 25 out of 30 patients had enlargement of the pancreas. 11 of these showed focal enlargement and the rest (14 patients) showed diffuse enlargement. Peripancreatic fat stranding was noted in 21 cases. Phlegmonous changes were evident in 14 patients with involvement of the lesser sac, mesentery transverse mesocolon, and anterior pararenal spaces. 7 cases showed the involvement of more than one anatomical site. In our study, 3 patients had Grade “A,” 7 patients had Grade “B,” 15 patients had Grade “C,” 1 patient had Grade “D,” and 4 patients had Grade “E” pancreatitis. In our study, CT severity index (CTSI) of 0-3 as seen in 16 patients, 4-6 was seen in 8 patients, and 7-10 was seen in 6 patients. Out of 4 patients who expired during the course of study, 3 had CTSI of more than 7 and those patients with CTSI of <3 had no complications, and there was no need of ICU stay for these patients. Conclusion: In all the cases, CT scan revealed the exact morphological appearance of the disease. CECT was very useful in staging acute pancreatitis using various CT numerical grading systems.