Diagnostic Possibilities of Computer Tomography and Ultrasonography in Necrotizing Pancreatitis

Abstract


Nowadays the main methods of radiological diagnostics that are used in the case of necrotizing pancreatitis are computer tomography (CT) and ultrasonography (US). US is preferable in diagnostics of necrotizing pancreatitis thanks to its availability, high-quality definition and possibility of mini-invasive interventions. At the same time there are some problems in defining the spreading of the desease as it’s difficult to get reliable visual information because of flatulence in intestinal and painfulness and tension of peritoneum. Besides the results of US depends a lot on experience and skills of the doctor performing it. CT is considered to be the best method of visual research (it’s also called “the golden diagnostic standard” in pancreatology) that can provide many-sided information on the state of pancreas and retroperitoneal area. The CT is highly objective method in detecting the type and scale of damaged tissues in pancreas and parapancreatic tissue. CT can provide more distinct data about the size, shape, contour and structure of the pancreas, about the size of pancreatitis, about volume and location of liquids in retroperitoneal cellular tissue regardless of the state of the surrounding issues and organs. As well this method of diagnostics lets reveal pancreas and parapancreas abscesses, necrosis of retroperitoneal cellular tissue, existence of sequestrums , the state of bile-excreting flows, gastro-intestinal tract and vascular systems. Thus CT is a highly informative method in diagnostics of an accurate pancreatitis and its complications

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Author for correspondence.
Email: hospitalsurgery.vsmu@gmail.com

Russian Federation MD, Prof. of the Department of Hospital Surgery VSMU

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation MD, Prof., Chief of the Department of Hospital Surgery VSMU

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation Ph.D., Docent of the Department of Hospital Surgery VSMU

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation Ph.D., Docent of the Department of Hospital Surgery VSMU

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation Ph.D., Docent of the Department of Hospital Surgery VSMU

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation Graduate student of the Department of Hospital Surgery VSMU

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation Graduate student of the Department of Hospital Surgery VSMU

Volgograd State Medical University, 1 Pavshikh Bortsov Sq., Volgograd, 400131, Russian Federation

Email: author@vestnik-surgery.com

Russian Federation Graduate student of the Department of Hospital Surgery VSMU

  1. Agapov K.V., Egorov M.S., Dzutkoeva F.A., SHutov A.A. Rol' spiral'noj komp'yuternoj tomografii i magnitno-rezonansnoj tomografii v vybore lechebnoj taktiki pri ostrom pankreatite [The role of spiral computer tomography and magnetic resonance imaging in the choice of therapeutic tactics in acute pancreatitis.] Al'manah instituta hirurgii imeni A.V. Vishnevskogo, 2011; 6: 2: 124-125.
  2. Arablinskij A.V., SHabunin A.V., Lukin A.YU., Sidorova YU.V. Diagnostika, dinamicheskoe nablyudenie i vyrabotka taktiki u bol'nyh s ostrym pankreatitom (dannye komp'yuternoj tomografii i magnitno-rezonansnoj tomografii) [Diagnosis, monitoring and development of tactics in patients with acute pancreatitis (data from computed tomography and magnetic resonance imaging).] Vestnik rentgenologii i radiologii, 2012; 2: 4-12.
  3. Andreev A.V. Dopplerografiya magistral'nyh arterial'nyh sosudov bryushnoj polosti v diagnostike i prognozirovanii techeniya ostrogo pankreatita [Dopplerography of the main arterial vessels of the abdominal cavity in the diagnosis and prognosis of acute pancreatitis.] Dis. kand. med. nauk. Obninsk. 2003; 168.
  4. Bagnenko S.F., Tolstoj A.D., Krasnogorov V.B. Ostryj pankreatit (Protokoly diagnostiki i lecheniya) [Acute pancreatitis (Protocols of diagnostics and treatment).] Annaly hirurgicheskoj gepatologii, 2006; 11: 1: 60-66.
  5. Voronov A.N. Diagnostika i lechenie inficirovannogo pankreonekroza [Diagnosis and treatment of infected pancreatic necrosis.] Ukrainskij zhurnal hirurgii, 2011; 3: 219-224.
  6. Gostishchev V.K., Afanas'ev A.N., Ustimenko A.V. Diagnostika i lechenie oslozhnennyh postnekroticheskih kist podzheludochnoj zhelezy [Diagnosis and treatment of the complications of postnecrotic cysts of the pancreas.] Hirurgiya, 2006; 6: 4-7.
  7. Ermolov A.S., Ivanov P.A., Blagovestnov D.A., Grishin A.A. Diagnostika i lechenie ostrogo pankreatita [Diagnosis and treatment of acute pancreatitis.] VIDAR, 2013; 384.
  8. Istomin N.P., Agapov K.V., Egorov M.S., Dzutkoeva F.A. SKT i MRT v vybore hirurgicheskoj taktiki pri ostrom pankreatite [CT and MRI in the choice of surgical tactics in acute pancreatitis.] Al'manah instituta hirurgii imeni A.V. Vishnevskogo, 2012; 7: 1: 190-191.
  9. Karmazanovskij G.G. Guzeeva E.B. KT s kontrastnym usileniem v diagnostike pankreatitov [CT with contrast enhancement in the diagnosis of pancreatitis.] Medicinskaya vizualizaciya, 1999; 2: 41–48.
  10. Kubyshkin V.A., Karmazanovskij G.G., Grishankov S.A. Kistoznye opuholi podzheludochnoj zhelezy: diagnostika i lechenie [Cystic tumors of the pancreas: diagnosis and treatment.] VIDAR, 2013; 328.
  11. Maksimova M.A., Filimonov M.I., Karmazanovskij G.G. Vozmozhnosti komp'yuternoj tomografii v ocenke stepeni tyazhesti ostrogo pankreatita i prognozirovaniya ego iskhoda [Possibilities of computed tomography in the assessment of severity of acute pancreatitis and prognosis of its outcome.] Medicinskaya vizualizaciya, 2010; 1: 130-132.
  12. Paklina O.V., Karmazanovskij G.G., Setdikova G.R. Patomorfologicheskaya i luchevaya diagnostika hirurgicheskih zabolevanij podzheludochnoj zhelezy [Pathologic and radiologic diagnosis of surgical diseases of the pancreas.] VIDAR, 2014; 188.
  13. Savel'ev V.S., Filimonov M.I., Burnevich S.Z. Pankreonekrozy. [Pankreonekroz.] M.: MIA, 2008; 259.
  14. Sahno V.D. Pankreonekroz. Diagnostika i obosnovanie differencirovannogo vybora metodov lecheniya [Diagnosis and rationale for a differentiated choice of treatment methods.] Dis. dokt. med. nauk. Moskva, 2007; 215.
  15. Fel'dsherov M.V., Nudnov N.V. Luchevaya diagnostika ostrogo pankreatita, ego form i iskhodov [Radiologic diagnosis of acute pancreatitis, its forms and outcomes.] Medicinskaya vizualizaciya, 2011; 1: 129-130.
  16. Attasarania S., Pais S., LeBlanc J. Endoscopic ultrasound – guided fine needle aspiration and cyst fluid analysis for pancreatic cysts. [Endoscopic ultrasound – guided fine needle aspiration and cyst fluid analysis for pancreatic cysts.] J. Pancreas, 2007; 8: 553–563.
  17. Balthazar E.J., Megibov A.J., Pozzi M.R. Imaging of the pancreas acute and chronic pancreatitis. [Imaging of the pancreas acute and chronic pancreatitis.] Berlin, Heidelberg: Spriger–Verlag, 2009; 390.
  18. Baron N.H., Morgan D.E. Acute necrotizing pancreatitis. [Acute necrotizing pancreatitis.] The New England Journal of medicine, 1999; 340: 18: 1412-1417.
  19. Bradley E.L.III. Indication for surgery in necrotizing pancreatitis – a millennial review. [Indication for surgery in necrotizing pancreatitis – a millennial review.] J. Pancreas, 2000; 1: 1: 1-3.
  20. Buchler M.W. Acute necrotizing pancreatitis: Treatment strategy according to the status of infection. [Acute necrotizing pancreatitis: Treatment strategy according to the status of infection.] Ann.Surg., 2000; 232: 619-626.
  21. Gerke H., Jaffe T.A., Mitchell R.M. Endoscopic ultrasound and computer tomography are inaccurate methods of classityng cystic pancreatic lesions. [Endoscopic ultrasound and computer tomography are inaccurate methods of classityng cystic pancreatic lesions.] Digestive Liver Dis., 2006; 38: 39–44.
  22. Isenmann R., Rau B., Beger H.G. Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis. [Bacterial infection and extent of necrosis are determinants of organ failure in patients with acute necrotizing pancreatitis.] Br. J. Surg., 1999; 86: 1020-1024.
  23. JAP guidelines for surgical management of acute pancreatitis. [JAP guidelines for surgical management of acute pancreatitis.] Pancreatology, 2002; 2: 565-573.
  24. Kumar P., Mukhopadhyay S., Sandhu M. et al. Ultrasonography computed tomography and percutaneous intervention in acute pancreatitis: A serial study. [Ultrasonography computed tomography and percutaneous intervention in acute pancreatitis: A serial study.] Austral. Radiology, 1995; 39: 2: 107-111.
  25. Lange J.F., Teng H.T., Menu M., Ham A.C. The role computed tomography in the management of acute pancreatitis. [The role computed tomography in the management of acute pancreatitis.] Acta. Chir. Scand., 1998; 154: 7-8: 461-465.
  26. Laws H.L., Kent R.B. 3rd. Acute pancreatitis: management of complicating infection. [Acute pancreatitis: management of complicating infection.] Am. Surg., 2000; 66: 145-152.
  27. Ranson J.H. Acute pancreatitis. Current Surgical Therapy. [Acute pancreatitis. Current Surgical Therapy.] Ed. J.L.Cameron. St. Louis.: Mosby, 1995; 408-418.
  28. Repiso Ortega A., Gomez-Rodriguez R., Romero M. Prospective Comparison of Endoscopic Ultrasonography and Magnetic Resonance Cholangiopancreatography in the Etiological Diagnosis of “Idiopathic” Acute Pancreatitis. [Prospective Comparison of Endoscopic Ultrasonography and Magnetic Resonance Cholangiopancreatography in the Etiological Diagnosis of “Idiopathic” Acute Pancreatitis.] Pancreas, 2011; 2: 289-294.
  29. Sashi M., Ercke A. Klassifikationen der Acuten Pankreatitis aus Chirurgieher Sicht. [Klassifikationen der Acuten Pankreatitis aus Chirurgieher Sicht.] Art Chir., 1993; 28: 3: 95.
  30. Tonsi A.F., Bacchion M., Crippa S., Malleo G., Bassi C. Acute pancreatitis at the beginning of the 21-century: The state of the art. [Acute pancreatitis at the beginning of the 21-century: The state of the art.] World. J. Gastroenterol., 2009; 5: 24: 2945-2959.

Views

Abstract - 88

PDF (Russian) - 323

PlumX

Dimensions


Copyright (c) 2014 ., ., ., ., ., ., ., .

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies