ACR Appropriateness Criteria ® Acute Pancreatitis

Acute pancreatitis (AP) is divided into two types: interstitial edematous and necrotizing. AP severity is classified clinically into mild, moderately severe, and severe, depending on the presence and persistence of organ failure and local or systemic complications. The revised Atlanta classification divides the clinical course of AP into an early (first week) and late phase (after first week) and the clinical phase determines the role of imaging. Imaging has a limited role in the early phase. In the early phase with typical presentations of AP, ultrasound is usually the only appropriate modality and is used for the detection of gallstones.
Source: Journal of the American College of Radiology : JACR - Category: Radiology Authors: Tags: Appropriate use criteria Source Type: research

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AbstractUltrasound plays an essential role in the initial evaluation of patients with suspected or confirmed acute pancreatitis. In addition to evaluation of the pancreatic parenchyma, ultrasound is used for assessment of the gallbladder, biliary tree, peripancreatic tissues, and regional vascular structures. While enlarged and edematous pancreas are classic sonographic features of acute pancreatitis, the pancreas may appear sonographically normal in the setting of acute pancreatitis. Nonetheless, sonographic evaluation in this setting is valuable because assessment for etiologic factors such as gallstones or evidence of b...
Source: Abdominal Imaging - Category: Radiology Source Type: research
Publication date: November 2019Source: Journal of the American College of Radiology, Volume 16, Issue 11, SupplementAuthor(s): Expert Panel on Gastrointestinal Imaging, Kristin K. Porter, Atif Zaheer, Ihab R. Kamel, Jeanne M. Horowitz, Hina Arif-Tiwari, Twyla B. Bartel, Mustafa R. Bashir, Marc A. Camacho, Brooks D. Cash, Victoria Chernyak, Alan Goldstein, Joseph R. Grajo, Samir Gupta, Nicole M. Hindman, Aya Kamaya, Michelle M. McNamara, Laura R. CarucciAbstractAcute pancreatitis (AP) is divided into two types: interstitial edematous and necrotizing. AP severity is classified clinically into mild, moderately severe, and sev...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
Conclusions: Our study is the first to report that endoscopic therapy of PFCs using LAMS is safe and effective even in a community hospital setting with limited resources and support compared to large academic centers. PMID: 31615198 [PubMed - as supplied by publisher]
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
Gallstone disease is a common clinical problem that leads to pancreatitis and cholangitis if left undiagnosed. Guidelines from the American Society for Gastrointestinal Endoscopy (ASGE) categorize patients with suspected choledocholithiasis (CDL) into 3 risk categories (low, intermediate, high) based on prognostic indicators. When compared to endoscopic ultrasound (EUS), these guidelines may result in unnecessary endoscopic retrograde cholangiopancreatographies (ERCPs) and associated complications.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Tuesday abstract Source Type: research
BY KATHRYN M. DEPRIMO &KHALID MALIK, MDA 30-year-old man with no previous medical history presented with one day of epigastric pain, nausea, and vomiting. He described the pain as moderate, aching, and nonradiating. He said Tylenol provided minimal relief.The patient reported vomiting four or five times since the start of his symptoms and described the vomit as yellow in color. He had no history of recent travel, recent sick contacts, trauma, pain with eating, fever, chills, shortness of breath, chest pain, headaches, dizziness, changes in bowel movements, or urination. The patient confirmed a past surgical histor...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Publication date: Available online 30 October 2018Source: Journal of Visceral SurgeryAuthor(s): M. Bougard, L. Barbier, B. Godart, A.-G. Le Bayon-Bréard, F. Marques, E. SalaméSummaryAcute pancreatitis is a frequent pathology with 11,000 to 13,000 new cases per year in France. A biliary origin (30 to 70% of the cases) should be suspected when alanine amino-transferases are elevated during the first 48 hours, and it is confirmed by the presence of gallstones at trans abdominal ultrasound. Abdominal computed-tomography scan is performed around the fifth day, and is repeated according to clinical and biological e...
Source: Journal of Visceral Surgery - Category: Surgery Source Type: research
CONCLUSION: The annual incidence rate of AP is relatively low in Qatar and tends to behave similar to many European countries in etiology, which can be explained by population structure. Gallstone and alcohol consumption are the main causes, and idiopathic AP is responsible for more cases than expected. PMID: 30301711 [PubMed - as supplied by publisher]
Source: The Turkish Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: Turk J Gastroenterol Source Type: research
ConclusionsConcomitant PC during gastric surgery for malignancies, although reducing the absolute number of biliary abnormalities, has no significant impact on the natural course of patients.
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
Authors: Garber A, Frakes C, Arora Z, Chahal P Abstract Acute pancreatitis represents a disorder characterized by acute necroinflammatory changes of the pancreas and is histologically characterized by acinar cell destruction. Diagnosed clinically with the Revised Atlanta Criteria, and with alcohol and cholelithiasis/choledocholithiasis as the two most prominent antecedents, acute pancreatitis ranks first amongst gastrointestinal diagnoses requiring admission and 21st amongst all diagnoses requiring hospitalization with estimated costs approximating 2.6 billion dollars annually. Complications arising from acute panc...
Source: Gastroenterology Research and Practice - Category: Gastroenterology Tags: Gastroenterol Res Pract Source Type: research
Abstract Most cases of acute pancreatitis are related to gallstones. More than 80% resolve within a few days. The diagnosis is based on upper abdominal pain, elevated lipase and/or amylase, and transabdominal ultrasound findings. Management requires early aggressive hydration, pain control, nutritional support, and monitoring for progression. Patients who develop hypovolemia, systemic inflammatory response, pancreatic necrosis, and organ failure have high mortality, risk of recurrence, and progression to chronic pancreatitis (CP). Genetic predisposition and repeated injury may be necessary for CP. Management requi...
Source: Primary Care - Category: Primary Care Authors: Tags: Prim Care Source Type: research
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