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A contrast-enhanced CT scan is usually performed more than 48 hours after the onset of pain to evaluate for pancreatic necrosis and extrapancreatic fluid as well as predict the severity of the disease. CT scanning earlier can be falsely reassuring. [33] ERCP or an endoscopic ultrasound can also be used if a biliary cause for pancreatitis is ...
Abdominal imaging is associated with many potential uses for the different phases of contrast CT.The majority of abdominal and pelvic CT's can be performed using a single-phase, but the evaluation of some tumor types (hepatic/pancreatic/renal), the urinary collecting system, and trauma patients among others, may be best performed with multiple phases.
Acute pancreatitis (AP) is a sudden inflammation of the pancreas.Causes include a gallstone impacted in the common bile duct or the pancreatic duct, heavy alcohol use, systemic disease, trauma, elevated calcium levels, hypertriglyceridemia (with triglycerides usually being very elevated, over 1000 mg/dL), certain medications, hereditary causes and, in children, mumps.
Contrast-enhanced CT demonstrates a diffusely enlarged (sausage-shaped) pancreas. Diffuse irregular narrowing of the main pancreatic duct, and stenosis of the intrapancreatic bile duct on endoscopic retrograde cholangiopancreatography (ERCP). Rare pancreatic calcification or cyst formation. Marked responsiveness to treatment with corticosteroids.
The pancreatic duct requires visualisation in cases of pancreatitis. Ultrasound is frequently the first investigation performed on admission; although it has little value in the diagnosis of pancreatitis or its complications. contrast-enhanced computed tomography (MD-CECT) is the most used imaging technique.
CT Scans: More sensitive and specific than abdominal radiograph, revealing the extent of colonic dilatation, the transition point, and often associated peripancreatic inflammation or fluid collections. The colon cut-off sign is different from sentinel loop sign, where the dilated segment is a part of the small intestine.
The Ranson criteria form a clinical prediction rule for predicting the prognosis and mortality risk of acute pancreatitis. They were introduced in 1974 by the English-American pancreatic expert and surgeon Dr. John Ranson (1938–1995). [1]
However, there are no absolute contraindications to iodinated contrast, so the benefits needs to be weighted against the risks. [14] As with CT scans in general, the radiation dose can potentially increase the risk of radiation-induced cancer. The injection of iodinated contrast agents may sometimes lead to its extravasation. [15]