Role of contrast-enhanced computed tomography in the evaluation of acute pancreatitis according to the revised Atlanta classification

Abstract

Objective The aim of this study was to detect the role of contrast-enhanced computed tomography (CT) in the diagnosis of acute pancreatitis according to the revised Atlanta classification. Background Imaging plays a very important role in the management of pancreatitis. It assists diagnosis and in differentiation of the severity of pancreatitis. Besides, it helps to detect and manage the associated complications through image-guided drainage and aspiration. Contrast-enhanced CT is the most clinically useful study. In 1992, morphological stages of acute pancreatitis were made. Between interstitial pancreatitis and sterile or infected necrosis Atlanta classification was made whereas in the revised Atlanta classification focuses heavily on the morphologic criteria for defining the various manifestations by means of CT. Materials and methods This prospective study was performed on 60 patients. The study was carried out at the Diagnostic Radiology Departments of Menoufia University Hospital and the National Liver Institute. The patients were presenting with acute abdominal pain, mainly epigastric, radiating to the back and the lesions were classified according to the Atlanta classification. Results Forty-two patients were with interstitial pancreatitis, 32 patients were with acute peripancreatic collection and 10 patients were with pseudocysts and 18 patients were with necrotizing pancreatitis, nine patients with acute necrotic collection and nine patients were with walled-off necrosis with statistically significant difference of age between groups (P = 0.014). Conclusion Contrast-enhanced CT is a perfect diagnostic modality to stage the severity of inflammatory process, identify the pancreatic necrosis and describe local complications and grading of severity of acute pancreatitis. Revised Atlanta classification is more accurate for assessing patient mortality and organ failure.