Efficacy of transabdominal sonography and contrast enhanced multidetector CT in the evaluation of pancreatitis and its complications

Abstract

Purpose: Pancreatitis is associated with a broad spectrum of findings causing significant morbidity and mortality and substantial use of health care resources. Optimal management of pancreatitis requires meticulous imaging protocol. Ultrasonography (USG) and Computed Tomography (CT) has afforded rapid, accurate and non-invasive evaluation of pancreatitis & complications. Both of these offer modalities offer advantages of their own at different stages.Material and Methods: 50 consecutive patients referred with clinical suspicion of pancreatitis were subjected to USG and contrast enhanced CT scan. The findings of acute and chronic pancreatitis and their complications’ on both the modalities were tabulated and correlated. Results: CT had overall excellent visualisation of pancreas in all the cases and better delineation of per pancreatic inflammatory changes. Extrapancreatic and vascular complications were readily identifiable on CT. Ultrasound had better visualisation of pancreas as compared to the previous studies. However, the gland was not completely visualised in all the cases due to interference from the bowel gas. Ultrasound also proved to be more effective in the evaluation of gall stones, in the characterisation of contents within the per pancreatic collections & guiding interventions. Conclusion: Ultrasonography is non-invasive, quick, inexpensive widely available screening tool in the early diagnosis and follow up of pancreatitis. It has certain limitation due to bowel gas which may hinder the visualization of Pancreas. CT has a role in firmly establishing the diagnosis of pancreatitis and its complications. Thus it is seen that both USG and CT have complementary roles to play in the early diagnosis and follow up of patients of pancreatitis.