Principles of diagnostics and treatment of acute necrotising pancreatitis

Abstract

Acute necrotizing pancreatitis is a prevalent acute abdominal condition, presenting a wide array of clinical symptoms. These can vary from mild interstitial inflammation to severe forms, leading to significant regional and systemic complications. Even with advancements in treatment methods and critical care for acute pancreatitis, it continues to carry a high mortality rate. For a long time, contrast-enhanced CT has been regarded as the gold standard for diagnosing acute pancreatitis. However, there exists some inconsistency in the terminology used across both literature and guidelines, which can affect treatment outcomes and prognoses. This study focuses on the radiological terminology and classification of findings related to acute and necrotizing pancreatitis. We discuss recommendations and indications for using CT, MRI, and ultrasound diagnoses, along with their methodologies. In cases of infected pancreonecrosis, staged combined surgical treatments are often preferred. Merging laparoscopic and retroperitoneoscopic methods facilitates the effective removal of sequesters and purification of purulent areas. This combination results in a substantial reduction in complications and mortality when compared to laparotomic operations. The primary aim of this research is to amalgamate findings from both international and local studies, providing a holistic view of the developmental stages of acute necrotizing pancreatitis. This understanding is primarily derived from their radiologic characterizations and potential complications.