The Value of Modified Renal Rim Grade in Predicting Acute Kidney Injury Following Severe Acute Pancreatitis

Objective To retrospectively determine the value of modified renal rim grade (MRRG) in predicting acute kidney injury (AKI) in the early phase of severe acute pancreatitis (SAP). Methods This institutional review board–approved retrospective study included patients with SAP who underwent abdominal contrast-enhanced computed tomography (CT) within 48 hours after disease onset. Modified renal rim grade, renal rim grade, CT severity index, modified CT severity index, extrapancreatic inflammation on CT scores, and posterior pararenal (PPR) space involvement were assessed. Clinical data, including bedside index of severity in acute pancreatitis and New Japanese Severity Scoring system scores, were collected. Primary end points were AKI and mortality. Scores were evaluated by receiver operating characteristic curve analysis. Correlational analyses between MRRG scores and the other scores were performed with Spearman analysis. Result One hundred five consecutive patients were enrolled in our study. The areas under the curve (AUCs) of MRRG in predicting AKI (0.90) and mortality (0.83) were comparable to extrapancreatic inflammation on CT (0.89 and 0.85, P> 0.05) and were higher than those of the other CT scores (P
Source: Journal of Computer Assisted Tomography - Category: Radiology Tags: Abdominal Imaging Source Type: research

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ConclusionFMCTSI is a better CT index than MCTSI for predicting the severity and clinical outcomes of AP. Among the various FMCTSI parameters, TVFR-MCTSI is the best performer.
Source: Abdominal Imaging - Category: Radiology Source Type: research
ConclusionThe presented system provides a feasible mean for systematic assessment of CP imaging features. Imaging parameters based on quantitative assessment, as opposed to subjective assessments, have better reproducibility and should be preferred in the development of new grading systems for understanding pathophysiology and disease progression in CP.
Source: Abdominal Imaging - Category: Radiology Source Type: research
Abstract Severe acute pancreatitis remains a life-threatening condition, responsible for many disorders of homeostasis and organ dysfunction. By means of a mnemonic 'PANCREAS', eight important steps in the management of severe acute pancreatitis are highlighted. These steps follow the principle of goal-directed therapy and should be borne in mind after diagnosis and during clinical treatment. The first step is perfusion: the goal is to reach a central venous pressure of 12-15mmHg, urinary output 0.5-1ml/kg/hour and inferior vena cava collapse index greater than 48%. Next is analgesia: multimodal, systemic and comb...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
We present the case of a patient who presented with a 1-year history of intermittent nausea, bloating, and anorexia with computed tomography scan findings of a complex pancreatic cystic lesion, omental findings concerning for carcinomatosis, and ascites. She developed tender, erythematous, and hyperpigmented subcutaneous nodules on bilateral lower extremities that were first noted on admission. Pancreatic biopsy revealed pancreatic pseudocyst and laboratory findings on admission were consistent with pancreatitis and pancreatic ascites. Laparoscopic omental biopsies revealed multifocal, nodular fat necrosis and associated i...
Source: Pathology Case Reviews - Category: Pathology Tags: Case Reports Source Type: research
Pancreatic damage, in the form of pancreatitis, intestinal bacteria and glucose imbalance could be interrelated. The aim of this study was to investigate the breath hydrogen (H 2 ) and methane (CH 4 ), which can indicate small intestinal bacterial overgrowth (SIBO) status, and assess the link between SIBO and glucose tolerance in patients with acute pancreatitis (AP). This prospective study enrolled 75 patients who were admitted for AP. A glucose breath test (GBT) which detects breath hydrogen H 2 and CH 4 for SIBO with an oral glucose tolerance test (OGTT) for 120 min was simultaneously performed to determine SIBO a...
Source: Journal of Breath Research - Category: Respiratory Medicine Authors: Source Type: research
ConclusionGiant intra-abdominal cystic lesions cause significant discomfort due to its mass effect. Pre-operative investigations may not identify its cause. Surgical excision is recommended to diagnostic and therapeutic purposes.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
AbstractBackground There is a limited data on the radiation dose from computed tomography (CT) in patients with acute pancreatitis (AP). The present study evaluated the radiation dose from CT scans in patients with AP.MaterialA retrospective review of CT reports of patients with AP was conducted. The type of CT scan (non-contrast vs. single-phase vs. biphasic CT) was recorded. The mean number of CT scans and cumulative radiation dose was calculated. The indications and abnormalities on biphasic CT scans were recorded. The radiation doses between different types of the scan were compared.Results495 CT studies in 351 patie...
Source: Abdominal Imaging - Category: Radiology Source Type: research
CONCLUSION: CT is helpful in predicting GIF in patients with AP. PMID: 31950804 [PubMed - in process]
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
Authors: Matsubayashi H, Notohara K, Hruban RH, Satoh T, Kaneko J, Sato J, Ishiwatari H, Ashida R, Uesaka K, Kiyozumi Y, Ono H Abstract A 69-year-old woman with a family history of pancreatic cancer was referred because of imaging changes of a pancreas cyst. Magnetic resonance cholangiopancreatography showed a faintly dilated main pancreatic duct and a pancreas body cyst that had changed rapidly over the past year. Computed tomography demonstrated an emerging enhancing lesion in the pancreatic cyst. Endoscopic ultrasonography revealed an irregular-margined, heterogeneous-echoic pancreatic mass, without findings of ...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
AbstractThe immunotherapy revolution in cancer treatment involves a variety of specialists, not only oncologists, but also internal medicine physicians, endocrinologists, dermatologists, gastroenterologists, rheumatologists, and radiologists, introducing new scenarios and novel challenges in the diagnosis and management of a number of novel immune-related adverse events. Among these, immune checkpoint inhibitor-induced pancreatic injury has been described (occurring in up to 4% of patients) and has been reported to be responsible for visits to the emergency departments in up to 1.9% of patients treated with immune checkpoi...
Source: Targeted Oncology - Category: Cancer & Oncology Source Type: research
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