Aims and objectives
A study was designed to evaluate the predictive validity of routine laboratory tests for characterizing acute pancreatitis severity and compare them against contrast-enhanced CT scales,
the gold standard of grading severity in acute pancreatitis.
Furthermore,
the difference in laboratory markers in relation to the presence or absence of pancreonecrosis was assessed.
After that we designed and carried out a research to explain the obtained results.
Methods and materials
We retrospectively studied 78 patients (65 male and 13 female,
at the middle age of 55 ± 29 years) with acute pancreatitis admitted to the surgical department between November 2014 and November 2016.
Leukocytosis,
hematocrit,
creatinine,
creatinine clearance,
alpha-amylase,
C-reactive protein, [Na+] and [K+] were measured; and contrast – enhanced CT was performed; different scales were used to assess the severity of acute pancreatitis and the extent of pancreonecrosis.
To evaluate the severity of inflammation and the pancreonecrosis extend at the same time the CT...
Results
Middle correlation was observed between the hematocrit and the pancreonecrosis extent (r=-0,37), creatinine clearance and Balthazar score (r=-0,4),
[Na+] and pancreonecrosis extent (r=-0,36),
[Na+] and CT severity index (r=-0,36).
No laboratory parameter,
which differs significantly in relation to the presence or absence of pancreonecrosis was observed.
To identify the pathophysiological reasons of the strong correlation absence between the laboratory markers and CT scores we supported,
that there are two processes: inflammation and necrosis,
which make the opposite contribution to the laboratory pattern.
To check this...
Conclusion
Although laboratory results are associated with the intensiveness of inflammatory process in pancreas,
they can’t be used for assessment severity of acute pancreatitis and prediction extent of pancreonecrosis,
because the inflammation and necrosis make the opposite contribution to the laboratory pattern. Therefore,
contrast-enhanced CT is necessary in the primary examination of patients with the suspected acute pancreatitis.
Personal information
Sinitsyn Valentin Evgen’evich,
Head of Radiology Chair,
Professor in Fundamental medicine faculty of Moscow state university,
Head of Radiology Department in Moscow State University Hospital,
MD,
PhD.
E-mail:
[email protected]
Mershina Elena Aleksandrovna,
Head of Radiology Department in Moscow State University Hospital,
Assistant professor in Fundamental medicine faculty of Moscow State University,
MD,
PhD.
E-mail:
[email protected]
Akchurina Elvira Damirovna,
Radiologist of Radiology Department in Moscow State University Hospital,
Assistant professor in Fundamental medicine faculty of Moscow State University,
MD,
PhD.
E-mail:
[email protected]
Vorobyeva Ekaterina Andreevna,
Fundamental...
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