Learning objectives
To review the diagnostic and staging criteria for acute pancreatitis according to the 2012 revised Atlanta classification of acute pancreatitis in adults.
To exemplify through a series of cases the imaging timing and features of acute pancreatitis.
Background
Acute pancreatitis is defined as an acute inflammatory process of the pancreas with variable involvement of other local tissues and remote organ systems.
It is one of the most common causes of hospital admission for gastrointestinal disorders.
It has a variety of causes (gallstones and alcohol in the vast majority) and can range in severity from mild to severe and life threatening.
Despite the fact that mild acute pancreatitis (the most common form) has a very low mortality rate,
organ failure presence and infected necrosis...
Findings and procedure details
Image findings
Interstitial edematous pancreatitis (IEP) - the most common form of acute pancreatitis
diffuse pancreatic parenchyma enlargement (occasionally localised) due to inflammation
homogeneous enhancement by intravenous contrast agent (i.e.
no areas of pancreatic necrosis)
mild peripancreatic fat stranding or haziness
with or without peripancreatic fluid collections (with no solid component)
Necrotising pancreatitis
There are three forms of necrotising pancreatitis,
depending on location: pancreatic parenchymal necrosis alone,
peripancreatic necrosis alone and pancreatic parenchymal necrosis with peripancreatic necrosis (in 75% of patients with acute necrotising pancreatitis)...
Conclusion
Acute pancreatitis is an evolving,
dynamic condition and its severity may change during the course of the disease.
The revised Atlanta classification acts as a common language for radiologists,
gastroenterologists,
surgeons and pathologists.
Standardised radiological reporting is helpful for a better communication between clinicians,
treatment planning and precise comparison of results among different departments and institutions.
References
1.
Beger HG,
Rau B,
Isenmann R.
Natural history of necrotizing pancreatitis.
Pancreatology 2003;3(2):93–101
2.
Banks PA,
Bollen TL,
Dervenis C,
et al.
Classification of acute pancreatitis 2012: revision of the Atlanta classification and definitions by international consensus.
Gut 2013;62(1):102–111.
3.
The Pancreas Club,
Inc.
Revision of the Atlanta classification of acute pancreatitis.
Available at: http://pancreasclub.com/wp-content/uploads/2011/11/AtlantaClassification.pdf.
Published April 9,
2008.
Accessed October 1st,
2016.
4.
Thoeni RF.
The revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment.
Radiology...