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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Conclusion The diagnostic yield of EUS is higher than S-MRCP in patients with IAP. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, GermanyArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Original article Source Type: research
CONCLUSION: LPAC syndrome is easy to diagnose and treat; therefore, it should no longer be overlooked. To increase its detection rate, all patients who experience recurrent biliary symptoms following an episode of acute pancreatitis should undergo an ultrasound examination performed by a radiologist with knowledge of the disease. PMID: 32742573 [PubMed]
Source: World Journal of Hepatology - Category: Gastroenterology Tags: World J Hepatol Source Type: research
CONCLUSION: The use of laparoscopic ultrasound during laparoscopic cholecystectomy for the detection of common bile duct stone is safe, accurate and cost effective. Equipment and maintenance costs are quickly offset and hospital bed days can be saved with its use. PMID: 32538107 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
A 36-year-old man with a past medical history significant for antiphospholipid syndrome complicated by a cerebrovascular event requiring indefinite coumadin anticoagulation, presented for epigastric pain and vomiting of a few days duration. His blood work was unremarkable except for an elevated lipase (150) without meeting the acute pancreatitis criteria. An ultrasound of the abdomen was negative for cholelithiasis and unremarkable bile ducts. However, a CT showed edema around the portal confluence.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Oral abstracts Source Type: research
AbstractPancreatic pseudocysts (PPC) may arise in up to 20% of cases of acute pancreatitis and in up to 40% of chronic pancreatitis. [1] Chronic alcohol ‐induced pancreatitis is the most common cause of PPCs, followed by chronic gallstone pancreatitis. Even though 65% of PPC cases resolve spontaneously, persistent cases may require endoscopic or surgical treatment. [2] Nowadays, endoscopic ultrasound‐guided cystogastrostomy with a stent is a com mon procedure with growing acceptance which continues to demonstrate effectiveness. [3] Alternatively, a trans‐gastric cystogastrostomy as a surgical approach for PPC can be ...
Source: Journal of Hepato-Biliary-Pancreatic Sciences - Category: Gastroenterology Authors: Tags: HOW I DO IT Source Type: research
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
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