Tomography in pancreatitis, has anything changed?

Tomografía en pancreatitis, ¿Algo ha cambiado?

Severe acute pancreatitis is defined as that associated with organ failure and / or multisystem complications. In order to compare the ability of the APACHE II score and dynamic tomography (Balthazar Ranson Index), a study was carried out in which patients diagnosed with acute pancreatitis, between March 1999 and June 2000, participated. Total of patients, 60% were taken to surgery. The degree of correlation of the APACHE II with the severity of the clinical picture and the subsequent morbidity and mortality is excellent, while the dynamic tomography performed in the first 72 hours was not a good prognostic marker and, therefore, its usefulness in this situation is questionable.

1. Bradley LE III. A clinically based clasification system for acute pancreatitis. Summary of the Symposium on Acute Pancreatitis, Atlanta, GA. Arch Surg 1993;128: 586-590.

2. Schólmerich J, Messmann H Serum markers for acute pancretitis — mirages or meaningful? Acute pancreatitis Blackwell Wissenschafts-Verlag GmbH. Berlin 1999.

3. White EM, Wittenberg J, Mueller PR, et al. Pancreatic necrosis: CT manifestations. Radiology 1986;158:343-46.

4. Bradley EL, Frederick M, Ferguson C. Prediction of pancreatic necrosis by dynamic pancreatography. Ann Surg 1989;210:495-503.

5. Ranson JH, Balthazar E, Caccavale R, Cooper M. Computed tomography and the prediction of pancreatic abscess in pancreatitis. An Surg 1985; 201: 656-65.

6. Balthazar E, Robinsan D, Megibow A, Ranson JHC. Acute pancreatitis: Value of CT in establishing Prognosis. Radiology 1990; 174: 331-336.

7. London NJM, Leese T, Lavelle JM, West KP, et al. Rapid bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: a prospective study. Br J Surg 1991; 78(18):1452-1456.

8. Ranson JH. Diagnostic standards for acute pancreatitis. World J Surg 1997;21(2):136-42.

9. Lucarotti ME, Virjee J, Anderson D. Patient selection and timing of dynamic computed tomography in acute pancretitis. Br J Surg 1993; 80(11):1393-1395.

10. Agarwal N, Pitchumoni CS. Assessment of severity in acyte pancreatitis. Am J Gastroenterol 1991; 86:1385-1391.

11. London NJM, Neoptolemos JP, Lavelle J et al. Contrast- enhanced abdominal computed tomography scanning and prediction of severity of acute pancreatitis: a prospective study. Br J Surg 1989; 78: 268-272.

12. London NJM, Neoptolemos JP, Lavelle J, et al. Serial computed tomography scanning in acute pancreatitis: a prospective study. Gut 1989; 30: 397-403.

13. McMenamin D, Gates LK. A retrospective analysis of the effect of Contrast-Enhanced CT on the outcome of acute pancreatitis. Am J Gastroenterol 1996; 91(7):1384-1387.

14. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APA- CHE II: A severity of disease classification system. Crit Care Med 1985; 13: 818-829.

15. Larvin M, McMahon M. APACHE II score for assessment and monitoring of acute pancreatitis. Lancet 1989; 2: 201-204.

16. Wilson C, Heath DI, Imrie CW. Prediction of outcome in acute pancreatitis: a comparative study of APACHE II, clinical assessment and multiple factor scoring systems. Br J Surg 1990; 77:1260-1264.

17. Baron V, Gómez G, Riveros R. Pancreatitis aguda. Proto- colo de manejo - Estudio prospectivo. Servicio de Cirugía, Hospital de San José, Hospital Occidente de Kennedy 1996.

18. Lankisch P, Burchard-Reckert S et al. Morbidity and Mortality in 602 patients with acute pancreatitis seen between the years 1980-1994. Z Gastroenterol 1996; 34: 371-377.

19. Thomson S, Hendry W, McFarlane G Epidemiology and outcome of acute pancreatitis. Br J Surg 1987; 74: 398-401.

20. Russell R. Indications for Surgery: What has changed? Acute Pancreatitis; Blackwell Wissenschafts-Verlag GmbH. Berlin 1999.

21. Bradley EL III. Surgical indications and tecniques in necrotizing pancreatitis. Acute pancreatitis: diagnosis and therapy. Rayen press Ltd., New York 1994.

22. Mier J, Leon E, Castillo A. Early versus late necrosectomy in severe necrotizing pancreatitis. Am J Surg 1997;173: 71-75.