Evaluation of pancreatitis and its complications by ultrasound and computed tomography

Objective: To know the role of USG and CT in pancreatitis, compare the findings of USG with CT, correlate USG and CT findings with biochemical parameters, evaluate the occurrence of complications, and predict the outcome of patients with pancreatitis Materials and Methods: Ultrasound and CT (plain and contrast) evaluation was done in 55 patients clinically suspected of pancreatitis of all age groups and both sexes. The Ultrasound and CT findings were compared and correlated with the biochemical parameters. Cases are evaluated for the occurrence and complications & outcome .Discrepancies found between ultrasonographic and CT findings were analysed. Results: 55 cases were studied and they were subjected to USG and CT (plain and contrast). Most of the patients were males with male to female ratio 13:1. Most common etiology was chronic alcohol consumption (42 cases, 76.33%) followed by idiopathic (11 cases, 20%) and trauma (2 cases, 3.66%). Multiple sites of involvement (35 cases, 63.65%) was more common than focal involvement of pancreas. Severe form of pancreatitis (37 cases, 67.27%) was the most common type according to MCTSI. The most common complication was ascites (36 cases, 65.45%) followed by pseudocyst (31 cases, 56.36%) and pleural effusion (16 cases, 29.09%). Conclusion: The sensitivity of USG in detecting acute pancreatitis was 41.8% .The sensitivity of CT (pain and contrast) in detecting pancreatitis was 100%.Modified CT severity index shows significant correlation between severity of pancreatitis and patient outcome. Serum lipase is more accurate in detecting acute pancreatitis than serum amylase. Thus, from the present study it can be concluded that CT (plain and contrast) is superior in detecting and evaluating pancreatitis. Hence, CT (plain and contrast) should be performed in all cases of clinically suspected pancreatitis especially with positive serological findings.