J Korean Soc Radiol.  2019 Jul;80(4):704-716. 10.3348/jksr.2019.80.4.704.

Utility of Early CT in Patients with Suspected Acute Biliary Pancreatitis

Affiliations
  • 1Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. nnoleeter@naver.com
  • 2Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Abstract

PURPOSE
The purpose of this study was to investigate whether early CT scans are useful for improving the clinical management of acute biliary pancreatitis.
MATERIALS AND METHODS
We retrospectively reviewed 56 consecutive patients who experienced first attack of acute pancreatitis and underwent CT scans within 48 hours of symptom onset in the emergency department, between March 2015 and March 2016. CT images were retrospectively evaluated for absence or presence, and etiology of acute pancreatitis, and probability of biliary pancreatitis. Urgent procedures for acute pancreatitis were analyzed.
RESULTS
Of 56 patients, 54 (96.4%) showed acute pancreatitis and 23 (41.1%) had biliary pancreatitis on CT. The diagnostic accuracy, sensitivity, and specificity of CT-diagnosed biliary pancreatitis were 94.6% (53/56), 91.7% (22/24), and 96.9% (31/32), respectively. Of the 56 patients, 17 (30.4%) patients with biliary pancreatitis underwent urgent endoscopic retrograde cholangiopancreatography (ERCP) within 72 hours (mean time interval between CT and ERCP: 25.5 ± 19.8 hours; range: 2-67 hours). There was a significant difference in the urgent procedures between non-biliary and biliary pancreatitis groups (0 of 32 vs. 17 of 24, p < 0.001).
CONCLUSION
Early CT may be used in patients visiting hospital with suspected acute biliary pancreatitis to facilitate urgent treatment.


MeSH Terms

Cholangiopancreatography, Endoscopic Retrograde
Diagnostic Imaging
Emergency Service, Hospital
Humans
Pancreatitis*
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed
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