ABSTRACT NO-145. LEARNING OBJECTIVES To Define acute pancreatitis phases and its types [interstitial...
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Transcript of ABSTRACT NO-145. LEARNING OBJECTIVES To Define acute pancreatitis phases and its types [interstitial...
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SPECTRUM OF PANCREATITISABSTRACT NO-145
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LEARNING OBJECTIVES
To Define acute pancreatitis phases and its
types [interstitial edematous and necrotizing]
and naming the various fluid collections
[APFC,PSEUDOCYST,ANC,WON] as defined
by the REVISED NEW ATLANTA
CLASSIFICATION.
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The revised Atlanta classification
distinguishes an early phase (1st week) in
which clinical parameters determine
treatment from a later phase (after the 1st
week) in which treatment is determined on
the basis of clinical parameters and
morphologic criteria defined by CT.
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Severe acute pancreatitis is defined in the
first phase as organ failure lasting more
than 48 hours or death; and
during the second phase as persistent organ
failure, death, or complications resulting
from acute pancreatitis
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TYPE OF PANCREATITISInterstitial edematous pancreatitisAcute necrotizing pancreatitis 1.parenchymal necrosis 2.peripancreatic necrosis 3.combined type with or
with out infection
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TYPES OF PANCREATITIS – FLUID COLLECTION
INTERSTITIAL EDEMATOUS PANCREATITIS
• STERILE/INFECTED
<4 WEEKS-ACUTE PERI PANCREATIC FLUID COLLECTION
• STERILE/INFECTED
> 4 WEEKS –PANCREATIC PSEUDO CYST
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NECROTIZING TYPENECROTIZING PANCREATITIS
< 4 WEEKS-ACUTE NECROTIC COLECTION
• STERILE/INFECTED
> 4 WEEKS-WALLED OFF NECROSIS
• STERILE/INFECTED
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Intraparenchymal fluid collections due to
pancreatitis are referred to as ANCs or
WONs, not as pseudo cysts.
Pseudo cysts rarely become infected or require
intervention .
For sterile ANC or WON,
any need for drainage is based on the clinical
information; infected ANCs or WONs usually
require intervention
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INTERSTITIAL EDEMATOUS PANCREATITIS
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INTERSTITIAL EDEMATOUS PANCREATITIS
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INTERSTITIAL EDEMATOUS PANCREATITIS
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ACUTE NECROTIZING PANCREATITIS
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PANCREATIC PARENCHYMAL NECROSIS
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PANCREATIC PARENCHYMAL NECROSIS
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PANCREATIC PARENCHYMAL NECROSIS
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PERI PANCREATIC NECROSIS
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PERI PANCREATIC NECROSIS
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COMBINED TYPE-NECROSIS
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COMBINED TYPE-NECROSIS
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ACUTE NECROTIZING-INFECTIOUS
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ACUTE PERI PANCREATIC FLUID COLLECTION
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PANCREATIC PSEUDO CYST
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PANCREATIC PSEUDO CYST
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ACUTE NECROTIC COLLECTION
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ACUTE NECROTIC COLLECTION
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WALLED OFF NECROSIS
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WALLED OFF NECROSIS
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MULTI COMPARTMENTAL COLLECTIONLEFT PLEURAL COLLECTION
SUB CAPSULAR RENAL PSEUDO COLLECTION
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MULTI COMPARTMENTAL COLLECTIONLOCULATED SUB HEPATIC
LEFT PARACOLIC GUTTER
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MULTI COMPARTMENTAL COLLECTIONLESSER SAC PELVIC
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MULTI COMPARTMENTAL COLLECTION
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TAKE HOME MSG• Identification of necrosis & %
• Associated findings & complications
IEP/ANP
• Intra pancreatic pseudocyst
• Pancreatic abscess
Acute After 4 weeks
Pan / Peri panNecrosis walled of Pan / peri panNecrosis
Fluid collection Pseudocyst
• Infected - Air bubble/ pus aspiration – clinical sepsis
CT severity index - prognostication
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THANK YOU