Imaging guidelines for acute pancreatitis: when and when not to image

AbstractIn patients with acute pancreatitis (AP), diagnostic imaging is performed for various reasons, including the detection of the etiology (e.g., biliary obstruction caused by gallstones), diagnosis of pancreatitis in an unclear clinical setting, assessment of the severity of the process, and evaluation of its complications. In spite of the potential benefits of these imaging studies in the setting of AP, especially economic consequences but also medical risks are associated with diagnostic imaging, including increase of the effective radiation dose received by patients with AP and rising health care costs, frequently without impact on management. The rising incidence of acute pancreatitis in the Western world is escalating its financial burden with national health care expenses of over 2.5 billion dollars annually. Despite evidence-based national recommendations on utilization of diagnostic imaging in patients with AP, unnecessary imaging studies are still frequently performed, especially in the early hospital course. The purpose of this article is, therefore, to review the imaging guidelines for acute pancreatitis with regards to when and when not to image, with the aim to minimize inappropriate utilization.
Source: Abdominal Imaging - Category: Radiology Source Type: research

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Gallstone disease is the term commonly used to refer to gallstones that cause symptoms. There is a myriad of complications that can arise from gallstones: acute cholecystitis, xanthogranulomatous cholecystitis, emphysematous cholecystitis, gallbladder wall perforations, pericholecystic abscesses, Mirizzi syndrome, cholecystoenteric fistulas, choledocholithiasis, gallstone pancreatitis, porcelain gallbladder, gallbladder malignancies, and many more. The aim of this pictorial review is to revisit how multimodality imaging can help with the diagnosis of gallstone disease.
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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
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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Source: Korean J Gastroenter... - Category: Gastroenterology Authors: Tags: Korean J Gastroenterol Source Type: research
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Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
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