Abstracts

RETURN TO ABSTRACT LISTING


E2309. Pancreatitis: What the Radiologist Needs to Know
Authors
  1. Laura Machado; Mercy Catholic Medical Center
  2. Elsy Machado; Salford Royal Hospital
  3. Cristina Olivas; Mercy Catholic Medical Center
  4. Justin Mackey; Mercy Catholic Medical Center
Background
Acute pancreatitis constitutes an acute inflammatory condition with a wide range of severity. It represents a common hospital admission cause and carries potential threatening complications. According to the revised Atlanta classification for acute pancreatitis, diagnosis is made when two or more of the following are present: abdominal pain suggestive of pancreatitis, elevated (times 3) amylase or lipase and imaging findings compatible with pancreatitis. Therefore, Computed tomography (CT) is an extremely useful and accessible diagnostic tool. Accepted terminology includes classification into two categories: interstitial edematous pancreatitis and necrotizing pancreatitis. This educational exhibit is a pictorial review of acute and chronic pancreatitis with special attention to a variety of potential complications and how radiologists must be able to recognize and communicate them.

Educational Goals / Teaching Points
-Provide a practical approach to diagnosing acute pancreatitis using updated terminology according to the revised Atlanta classification -Rich case-based review of pancreatitis and its various complications. Also, approach to detecting possible causes of pancreatitis

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
-Pancreatic or peripancreatic fluid collections are present when acutely inflamed. Density of those fluid collections along with parenchymal enhancement will determine if necrotizing pancreatitis. To asses this, it is important to take into consideration time of abdominal pain since CT sensitivity is low in the early presentation -Appropriate CT technique is contrast enhanced with approximately 40 seconds delay to allow for pancreatic parenchymal contrast uptake. Contrast enhanced MRI will help characterize mass lesions in the pancreas when solid and cystic component as well as with adjacent complications such as fistula formation -Interventional radiology can provide prompt treatment to vascular complications such as pseudoaneurysm formation

Conclusion
Radiologists must be able to recognize and describe these types of pancreatitis and most importantly their potential complications. These complications range from infections to perforations and vascular insults. Also, with use of the proper terminology which allows for a universal understanding and be familiar with appropriate management.