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Gastrointestinal
Diagnosis
Pancreas
Inflammation
Acute Pancreatitis and Complications
Acute Pancreatitis and Complications
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Acute inflammation of pancreas with variable involvement of other regional tissues or remote organs

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Radiographic Findings

                    • Fluoroscopic Findings

                      • Angiographic Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                • Reporting Tips

                                                  Selected References

                                                  1. Dar G et al: CT severity indices derived from low monoenergetic images at dual-energy CT may improve prediction of outcome in acute pancreatitis. Eur Radiol. ePub, 2021
                                                  2. Hu X et al: The value of a dual-energy spectral CT quantitative analysis technique in acute pancreatitis. Clin Radiol. 76(7):551.e11-551.e15, 2021
                                                  3. Nepal P et al: Gas where it shouldn't be! imaging spectrum of emphysematous infections in the abdomen and pelvis. AJR Am J Roentgenol. 216(3):812-23, 2021
                                                  4. Trout AT et al: Current state of imaging of pediatric pancreatitis: AJR expert panel narrative review. AJR Am J Roentgenol. ePub, 2021
                                                  5. Boxhoorn L et al: Acute pancreatitis. Lancet. 396(10252):726-34, 2020
                                                  6. Gupta P et al: Variability of contrast enhancement of pancreas on computed tomography in patients with acute pancreatitis and isolated extrapancreatic necrosis. Acta Gastroenterol Belg. 83(4):593-7, 2020
                                                  7. Vacca G et al: Magnetic resonance severity index assessed by T1-weighted imaging for acute pancreatitis: correlation with clinical outcomes and grading of the revised Atlanta classification-a narrative review. Gland Surg. 9(6):2312-20, 2020
                                                  8. Porter KK et al: Acute pancreatitis: how can MR imaging help. Magn Reson Imaging Clin N Am. 26(3):439-50, 2018
                                                  9. Stigliano S et al: Early management of acute pancreatitis: a review of the best evidence. Dig Liver Dis. 49(6):585-94, 2017
                                                  10. Forsmark CE et al: Acute pancreatitis. N Engl J Med. 375(20):1972-81, 2016
                                                  11. Foster BR et al: Revised Atlanta classification for acute pancreatitis: a pictorial essay. Radiographics. 36(3):675-87, 2016
                                                  12. Baker ME et al: ACR Appropriateness Criteria® acute pancreatitis. Ultrasound Q. 30(4):267-73, 2014
                                                  13. Bakker OJ et al: Treatment options for acute pancreatitis. Nat Rev Gastroenterol Hepatol. 11(8):462-9, 2014
                                                  14. Murphy KP et al: Updated imaging nomenclature for acute pancreatitis. AJR Am J Roentgenol. 203(5):W464-9, 2014
                                                  15. Shinagare AB et al: Use of CT and MRI in emergency department patients with acute pancreatitis. Abdom Imaging.40(2):272-7, 2014
                                                  16. Shyu JY et al: Necrotizing pancreatitis: diagnosis, imaging, and intervention. Radiographics. 34(5):1218-39, 2014
                                                  17. Türkvatan A et al: Imaging of acute pancreatitis and its complications. Part 1: acute pancreatitis. Diagn Interv Imaging. 96(2):151-60, 2014
                                                  18. Türkvatan A et al: Imaging of acute pancreatitis and its complications. Part 2: complications of acute pancreatitis. Diagn Interv Imaging. 96(2):161-9, 2014
                                                  19. Verde F et al: Arterial pseudoaneurysms complicating pancreatitis: literature review. J Comput Assist Tomogr. 39(1):7-12, 2014
                                                  20. Schepers NJ et al: Early management of acute pancreatitis. Best Pract Res Clin Gastroenterol. 27(5):727-43, 2013
                                                  21. Zaheer A et al: The revised Atlanta classification for acute pancreatitis: updates in imaging terminology and guidelines. Abdom Imaging. 38(1):125-36, 2013
                                                  22. Sheu Y et al: The revised Atlanta classification for acute pancreatitis: a CT imaging guide for radiologists. Emerg Radiol. 19(3):237-43, 2012
                                                  23. Thoeni RF: The revised atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment. Radiology. 262(3):751-64, 2012
                                                  24. Sigounas DE et al: New prognostic markers for outcome of acute pancreatitis: overview of reporting in 184 studies. Pancreas. 40(4):522-32, 2011
                                                  25. Kiriyama S et al: New diagnostic criteria of acute pancreatitis. J Hepatobiliary Pancreat Sci. 17(1):24-36, 2010
                                                  26. Darge K et al: Pancreatitis and the role of US, MRCP and ERCP. Pediatr Radiol. 39 Suppl 2:S153-7, 2009
                                                  27. Shinya S et al: The efficacy of diffusion-weighted imaging for the detection and evaluation of acute pancreatitis. Hepatogastroenterology. 56(94-95):1407-10, 2009
                                                  28. Tkacz JN et al: MR imaging in gastrointestinal emergencies. Radiographics. 29(6):1767-80, 2009
                                                  Related Anatomy
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                                                  Related Differential Diagnoses
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                                                  References
                                                  Tables

                                                  Tables

                                                  KEY FACTS

                                                  • Terminology

                                                    • Imaging

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Definitions

                                                            • Acute inflammation of pancreas with variable involvement of other regional tissues or remote organs

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Radiographic Findings

                                                                    • Fluoroscopic Findings

                                                                      • Angiographic Findings

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Staging, Grading, & Classification

                                                                                • Gross Pathologic & Surgical Features

                                                                                  • Microscopic Features

                                                                                    CLINICAL ISSUES

                                                                                    • Presentation

                                                                                      • Demographics

                                                                                        • Natural History & Prognosis

                                                                                          • Treatment

                                                                                            DIAGNOSTIC CHECKLIST

                                                                                            • Consider

                                                                                              • Image Interpretation Pearls

                                                                                                • Reporting Tips

                                                                                                  Selected References

                                                                                                  1. Dar G et al: CT severity indices derived from low monoenergetic images at dual-energy CT may improve prediction of outcome in acute pancreatitis. Eur Radiol. ePub, 2021
                                                                                                  2. Hu X et al: The value of a dual-energy spectral CT quantitative analysis technique in acute pancreatitis. Clin Radiol. 76(7):551.e11-551.e15, 2021
                                                                                                  3. Nepal P et al: Gas where it shouldn't be! imaging spectrum of emphysematous infections in the abdomen and pelvis. AJR Am J Roentgenol. 216(3):812-23, 2021
                                                                                                  4. Trout AT et al: Current state of imaging of pediatric pancreatitis: AJR expert panel narrative review. AJR Am J Roentgenol. ePub, 2021
                                                                                                  5. Boxhoorn L et al: Acute pancreatitis. Lancet. 396(10252):726-34, 2020
                                                                                                  6. Gupta P et al: Variability of contrast enhancement of pancreas on computed tomography in patients with acute pancreatitis and isolated extrapancreatic necrosis. Acta Gastroenterol Belg. 83(4):593-7, 2020
                                                                                                  7. Vacca G et al: Magnetic resonance severity index assessed by T1-weighted imaging for acute pancreatitis: correlation with clinical outcomes and grading of the revised Atlanta classification-a narrative review. Gland Surg. 9(6):2312-20, 2020
                                                                                                  8. Porter KK et al: Acute pancreatitis: how can MR imaging help. Magn Reson Imaging Clin N Am. 26(3):439-50, 2018
                                                                                                  9. Stigliano S et al: Early management of acute pancreatitis: a review of the best evidence. Dig Liver Dis. 49(6):585-94, 2017
                                                                                                  10. Forsmark CE et al: Acute pancreatitis. N Engl J Med. 375(20):1972-81, 2016
                                                                                                  11. Foster BR et al: Revised Atlanta classification for acute pancreatitis: a pictorial essay. Radiographics. 36(3):675-87, 2016
                                                                                                  12. Baker ME et al: ACR Appropriateness Criteria® acute pancreatitis. Ultrasound Q. 30(4):267-73, 2014
                                                                                                  13. Bakker OJ et al: Treatment options for acute pancreatitis. Nat Rev Gastroenterol Hepatol. 11(8):462-9, 2014
                                                                                                  14. Murphy KP et al: Updated imaging nomenclature for acute pancreatitis. AJR Am J Roentgenol. 203(5):W464-9, 2014
                                                                                                  15. Shinagare AB et al: Use of CT and MRI in emergency department patients with acute pancreatitis. Abdom Imaging.40(2):272-7, 2014
                                                                                                  16. Shyu JY et al: Necrotizing pancreatitis: diagnosis, imaging, and intervention. Radiographics. 34(5):1218-39, 2014
                                                                                                  17. Türkvatan A et al: Imaging of acute pancreatitis and its complications. Part 1: acute pancreatitis. Diagn Interv Imaging. 96(2):151-60, 2014
                                                                                                  18. Türkvatan A et al: Imaging of acute pancreatitis and its complications. Part 2: complications of acute pancreatitis. Diagn Interv Imaging. 96(2):161-9, 2014
                                                                                                  19. Verde F et al: Arterial pseudoaneurysms complicating pancreatitis: literature review. J Comput Assist Tomogr. 39(1):7-12, 2014
                                                                                                  20. Schepers NJ et al: Early management of acute pancreatitis. Best Pract Res Clin Gastroenterol. 27(5):727-43, 2013
                                                                                                  21. Zaheer A et al: The revised Atlanta classification for acute pancreatitis: updates in imaging terminology and guidelines. Abdom Imaging. 38(1):125-36, 2013
                                                                                                  22. Sheu Y et al: The revised Atlanta classification for acute pancreatitis: a CT imaging guide for radiologists. Emerg Radiol. 19(3):237-43, 2012
                                                                                                  23. Thoeni RF: The revised atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment. Radiology. 262(3):751-64, 2012
                                                                                                  24. Sigounas DE et al: New prognostic markers for outcome of acute pancreatitis: overview of reporting in 184 studies. Pancreas. 40(4):522-32, 2011
                                                                                                  25. Kiriyama S et al: New diagnostic criteria of acute pancreatitis. J Hepatobiliary Pancreat Sci. 17(1):24-36, 2010
                                                                                                  26. Darge K et al: Pancreatitis and the role of US, MRCP and ERCP. Pediatr Radiol. 39 Suppl 2:S153-7, 2009
                                                                                                  27. Shinya S et al: The efficacy of diffusion-weighted imaging for the detection and evaluation of acute pancreatitis. Hepatogastroenterology. 56(94-95):1407-10, 2009
                                                                                                  28. Tkacz JN et al: MR imaging in gastrointestinal emergencies. Radiographics. 29(6):1767-80, 2009