Radiation dose from computed tomography in patients with acute pancreatitis: an audit from a tertiary care referral hospital

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 patients were evaluated. In patients (n = 78, 22.2%) undergoing multiple CT scans, mean number of CT scans per patient and mean radiation dose were 2.64 ± 1.18 (range 2–9) and 24 ± 15 mSv (range 8.3–79.8 mSv), respectively. The mean radiation dose was significantly greater in patients with modified CT severity index  ≥ 8 (n = 63) [25.08 mSv vs. 18.96 mSv, (P  =  0.048)]. 61 (12.32%) biphasic scans were performed. A definite indication for a biphasic CT scan was identified in 20 (32.7%) patients. Arterial abnormalities were detected in 6 (9.8%) patients undergoing CT for defined indication. Mean radiation dose in this group was 13.26 ± 7.64 mSv (ran ge 3.42–38.27 mSv) which was significantly great...
Source: Abdominal Imaging - Category: Radiology Source Type: research

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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
Endoscopy DOI: 10.1055/a-1075-4080 Prophylaxis 1 ESGE recommends routine rectal administration of 100 mg of diclofenac or indomethacin immediately before endoscopic retrograde cholangiopancreatography (ERCP) in all patients without contraindications to nonsteroidal anti-inflammatory drug administration.Strong recommendation, moderate quality evidence. 2 ESGE recommends prophylactic pancreatic stenting in selected patients at high risk for post-ERCP pancreatitis (inadvertent guidewire insertion/opacification of the pancreatic duct, double-guidewire cannulation).Strong recommendation, moderate quality...
Source: Endoscopy - Category: Gastroenterology Authors: Tags: Guideline Source Type: research
Abstract Scrub typhus has a variety of clinical presentations ranging from asymptomatic to fever with chills, myalgias, hepatitis, gastric ulcerations and pancreatitis, all being attributed to disseminated vasculitis, with splenic infarction being a rare presentation. A 26-year man, a resident of north India, presented with an acute febrile illness and abdominal pain, computed tomography scan of the abdomen was suggestive of a splenic infarct. After ruling out other aetiology, a positive IgM (ELISA) for scrub typhus led to treatment with oral doxycycline, following which the patient was discharged symptom-free. Ra...
Source: Tropical Doctor - Category: Tropical Medicine Authors: Tags: Trop Doct Source Type: research
Publication date: November 2019Source: Human Pathology: Case Reports, Volume 18Author(s): Kevin Gowing, David F. Schaeffer, Hui-Min YangAbstractMucinous cystic neoplasm (MCN) is characterized by mucinous epithelial lining and subepithelial ovarian-like stroma and is a precursor to invasive carcinoma. Type 1 autoimmune pancreatitis (AIP), on the other hand, is a form of IgG4-related disease (IgG4-RD) and can present as a pancreatic mass. There is no known causal relationship between these two entities in the current literature. Here, we report a case of a middle-aged female patient who was found to have an enlarging pancrea...
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research
Acute occlusion of the abdominal aorta is an extremely rare disease. A 31-year-old man with history of neuroblastoma of the left adrenal gland in childhood treated with radiotherapy, chemotherapy and surgery was known to have secondary arterial hypertension due to renal artery stenosis. He also had poor alimentary habits with excessive alcohol and massive sugar consumption. He presented to hospital for acute bilateral limb ischemia with complete paralysis. Abdominal CT-scan revealed abdominal aortic occlusion below the renal arteries, associated with severe pancreatitis (plasma lipase  = 1459 UI/l) (Fig.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Pancreaticoduodenal artery aneurysm (PDA) is a rare visceral aneurysm and represents 1.5% of all the visceral arterial aneurysms. A 81-year old man was admitted with acute abdominal pain. He suffered 2 previous episodes of pancreatitis and he underwent abdominal aortic aneurysm repair eleven years before.The CT scan revealed a 92 mm aneurysm of inferior PDA artery with pre-rupture signs associated with the celiac trunk obstruction.The patient underwent a selective catheterization and embolization of superior PDA artery with coils, inferior PDA artery with 12 mm Amplatzer and aneurysm sac embolization by Onyx and coils.The ...
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
Pancreaticoduodenal artery aneurysm (PDA) is a rare visceral aneurysm and represents 1.5% of all the visceral arterial aneurysms. An 81-year-old man was admitted with acute abdominal pain. He suffered 2 previous episodes of pancreatitis and underwent abdominal aortic aneurysm repair 11 years before. The computed tomography scan revealed a 92-mm aneurysm of inferior PDA artery with prerupture signs associated with the celiac trunk obstruction. The patient underwent a selective catheterization and embolization of superior PDA artery with coils, inferior PDA artery with 12-mm Amplatzer, and aneurysm sac embolization by Onyx and coils.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Case Report Source Type: research
CONCLUSIONAwareness of the entity and use of ancillary techniques in making the pre-operative diagnosis could have saved the patient from an extensive surgical procedure.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
DISCUSSION: This Babcock technique with endoscopic necrosectomy has not been previously described in the literature, to our knowledge. Babcock forceps were an ideal tool in our case because they were able to gain access to the obstruction in the stent, but the "teeth" are small and dull enough to prevent from catching onto the metal stent mesh. PMID: 31314716 [PubMed - in process]
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
ConclusionThe clinicians should consider this rare condition in the differential diagnosis of patients presenting with large paraumbilical hernias associated with classical symptoms of acute pancreatitis, particularly in the absence of typical risk factors for pancreatitis. An intravenous contrast-enhanced abdominal CT scan should be performed immediately in these patients. We recommend the patients and the surgeons to consider prompt surgical repair for paraumbilical hernias to avoid further complications and the higher incidence of morbidity and mortality associated with emergency surgeries.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
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