Role of computed tomography in diagnosis, follow-up, and minimally invasive treatment of acute pancreatitis

Background
Acute pancreatitis is an inflammatory disease of the pancreas with variable involvement of other regional tissues or remote organ systems. It has a mild, self-limiting course in 80% of patients who recover without complications. The remaining patients have a severe disease with local and systemic complications, and this disease carries a mortality risk of 10–24%.
Objective
To examine the role of computed tomography (CT) in diagnosis, follow-up, and guided therapy in acute pancreatitis.
Patients and methods
The study was performed on 100 patients with acute pancreatitis from January 2014 to October 2016. There were 80 males and 20 females.
Inclusion criteria
Previously known acute pancreatitis attacks, clinically suspected acute pancreatitis, laboratory results suggesting acute pancreatitis, and patients with trauma with suspected pancreatic injury sequelae were the inclusion criteria. All patients were subjected to history taking; laboratory assessment, including serum amylase, lipase, creatinine levels, complete blood count, lipid profile (mainly triglyceride), and blood glucose; as well as CT scan to assess the pancreatic parenchyma, peripancreatic region, extrapancreatic ascites, pleural effusion, lung bases, and intestinal loops.
Results
The study included 100 patients whose age ranged from 9 to 83 years old, with a mean of 41.89 years. Overall, 80 (80%) patient were males and 20 (20%) patient were females. The CT showed sensitivity of 99.1% and specificity of 100% with positive predictive value of 100% and negative predictive value of 97% in the diagnosis of acute pancreatitis.
Conclusion
Acute pancreatitis can be severe and life-threatening. Imaging is central in the identification of complications, and radiological scoring systems can predict prognosis. With the current move toward minimally invasive treatment, the role of image-guided therapy is increasing and the need for surgical intervention is decreasing. CT is playing a golden role in diagnosis, follow-up, and guided therapy of acute pancreatitis.