Publication:

Acute pancreatitis, its diagnosis with special reference to contrast enhanced CT scan (CECT) and serum enzyme studies: a comparative study in tertiary referral hospital of Odisha, India

Background Acute pancreatitis is sudden swelling and inflammation of the pancreas. It can be diagnosed on the basis of clinical and laboratory data. At times, it may be difficult to differentiate it from other acute abdominal conditions. In these patients, serum enzymes (amylase and lipase) study, imaging by ultrasonography (USG) and/or computed tomography (CT) is of immense value in arriving at a diagnosis. In this study, we have compared the role of serum enzymes (amylase and lipase) levels, with the imaging studies (US/CECT scan) in relation to early diagnosis of acute pancreatitis and to find out the most specific and sensitive diagnostic modality.

Methods 300 patients (220 males, 80 females) in age group of 21 to 62 years with a clinical diagnosis of acute pancreatitis, which were admitted to surgical ward of S.C.B. Medical College Hospital, Cuttack during a period from November 2013 to October 2015, were included in the study. All selected cases (clinically diagnosed as acute pancreatitis) were serially subjected to tests of serum amylase and lipase estimation, USG and CECT scan of abdomen.

Results In our study the most common cause found was gall stone disease followed by chronic alcoholism. Serum amylase test showed diagnostic accuracy of 46.66% whereas serum lipase it was 70 %. Further USG of abdomen diagnostic accuracy was 83.33%, finally CECT scan had a diagnostic accuracy of 93.33%.

Conclusions Comparing all the diagnostic modalities described above it was found that contrast enhanced CT scan has highest accuracy rate (i.e. about 93% in our study) in detecting acute pancreatitis. This study proved that CECT scan was very important in the following up of the patients in order to detecting regression of disease appearance and complication in relation to acute pancreatitis.