Acute pancreatitis is a sudden inflammation of the pancreas connected with inappropriate activation of proenzymes,
what may lead to various severity damage of adjacent tissues and distant organs.
Main clinical symptoms of acute pancreatitis are: severe abdominal pain (epigastric region) – radiating to the back,
nausea and vomiting (worsened with eating),
fever,
reduction of bowel sounds.
Recognition and evaluation of acute pancreatitis undeniably require radiological diagnosis,
where Computed Tomography with intravenous contrast agents is considered the gold standard procedure.
However Computed Tomography is not recommended in the early stage of acute pancreatitis because of deficiency of its diagnostic value (equivocal or normal findings can be illustrated) – it matters only after 72 hours of onset of symptoms and after that period morphology and pancreatic necrosis can be assessed.
Fig. 1
To evaluate the CT image,
following scales are used: Balthazar scale (Table 1),
CTSI classification (Table 1),
EPIC scale (Table 2) and CTSI modified scale (Mortele).
They describe pancreas-located changes and extrapancreatic complications of acute pancreatitis.
Table 1: Description of Balthazar and CTSI scales.
Sample images: Fig. 2 Fig. 3 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 10
Table 2: Description of EPIC scale.
Sample images: Fig. 11 Fig. 12
Table 3: Description of Mortele scale.
Sample images: Fig. 13 Fig. 14
Treatment of acute pancreatitis is multidirectional and includes interventions on many medical fields,
such as: pharmacotherapy (including shock and pain control),
nutritional support,
endoscopic interventions and even surgery (Fig. 15). Accurate radiological evaluation of organ changes allows to implement specific methods of therapy (e.g.
ERCP) and it helps to avoid unnecessary exposure of extensive surgical intervention of patients at the same time (e.g.
open abdomen method).
Over the years,
gender considered as a risk factor of developing severe acute pancreatitis became an unclear issue.
Speculation occurred that estrogens have protective character towards the pancreas,
thus severity of pancreatitis of females is diminished.
However,
studies indicate conflicting results[1][2][3].
The aim of the study was to analyze relationship between gender and non-alcoholic acute pancreatitis severity rate specified in Computed Tomography examination and to present statistical summary of radiological evaluation of patients with non-alcoholic acute pancreatitis treated in the Department of Gastrointestinal Surgery at the Medical University of Silesia in Katowice,
in the time of 1th of January 2010 to 31th of November 2012,
described in Balthazar,
EPIC,
Mortele scales and CTSI classification.