Predicting the Severity of Acute Pancreatitis Using Ultrasound Markers and Clinical Scales
https://doi.org/10.23934/2223-9022-2022-11-2-274-279
Abstract
Abstract For the timely determination of the tactics of treatment of acute pancreatitis, it is necessary to predict the severity when the patient enters the hospital.
Aim of the study To assess the possibility of predicting the severity of acute pancreatitis using ultrasound markers, clinical scales.
Material and methods A retrospective analysis of the diagnostic results of 84 patients who were hospitalized for acute pancreatitis was carried out. The results of clinical-laboratory and morphological diagnostic methods obtained upon admission of a patient to a hospital in patients with varying degrees of severity of ap were analyzed. Clinical and laboratory data were analyzed using prognostic scales — marshall, ranson, sofa, bisap. The analysis of morphological changes in the pancreas during ultrasound and computed tomography was performed using the balthazar classification.
Results The sensitivity of clinical scales for determining the severity of ap was 67% on the sofa scale, 87.5% on the bisap scale, and 100% on the ranson and marshall scales. All patients (22) who had signs corresponding to the balthazar stage d and e upon ultrasound examination subsequently had a moderate and severe course of the disease.
Conclusion The use of ultrasonic markers of acute pancreatitis in conjunction with the data of clinical and laboratory scales makes it possible to predict the severity of acute pancreatitis.
About the Authors
V. A. Rudenko
Department of Functional and Ultrasound Diagnostics, Emergency Hospital; Bashkirsky State Medical University
Russian Federation
Russian Federation
Valeria A. Rudenko, Radiologist
39/2 Batyrskaya St., Ufa 450106, Republic of Bashkortostan, Russian Federation
3 Lenina St., Ufa 450008, Republic of Bashkortostan, Russian Federation
L. N. Kakaulina
Department of Functional and Ultrasound Diagnostics, Emergency Hospital; Bashkirsky State Medical University
Russian Federation
Russian Federation
Lucia N. Kakaulina - Head; Associate Professor of the Department of Radiation Diagnostics and Radiation Therapy, Nuclear Medicine and Radiotherapy with courses of the Institute of Continuing Professional Education
39/2 Batyrskaya St., Ufa 450106, Republic of Bashkortostan, Russian Federation
3 Lenina St., Ufa 450008, Republic of Bashkortostan, Russian Federation
I. V. Verzakova
Bashkirsky State Medical University
Russian Federation
Russian Federation
Irina V. Verzakova - Professor, Head of the Department of Radiation Diagnostics and Radiation Therapy, Nuclear Medicine and Radiotherapy
with courses of the Institute of Continuing Professional Education
3 Lenina St., Ufa 450008, Republic of Bashkortostan, Russian Federation
I. M. Karamova
Department of Functional and Ultrasound Diagnostics, Emergency Hospital
Russian Federation
Russian Federation
Irina M. Karamova - Doctor of Medical Sciences, Professor, Chief Physician
39/2 Batyrskaya St., Ufa 450106, Republic of Bashkortostan, Russian Federation
References
1. van Santvoort HC, Bakker OJ, Bollen TL, Besselink MG, Ali UA, Am S, et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 2011;141(4):1254–1263. PMID: PMID: 21741922 https://doi.org/10.1053/j.gastro.2011.06.073
2. Revishvili ASh, Fedorov AV, Sazhin VP, Olovianny VE. Emergency surgery in Russian Federation. Pirogov Russian Journal of Surgery. 2019;(3):88–97. (in Russ.). https://doi.org/10.17116/hirurgia201903188
3. Volkov V., Volkov S., Chesnokova N. Clinical Features and Therapeutic Approach in Case of Local Complications of Acute Pancreatic Necrosis in Light of New International Classification of Acute Pancreatitis-2012. Acta Medica Eurasica. 2015;(2):9–16. (in Russ.).
4. McPherson SJ, O’Reilly DA, Sinclair MT, Smith N. The use of imaging in acute pancreatitis in United Kingdom hospitals: findings from a national quality of care study. Br J Radiol. 2017;90(1080):20170224. PMID: 28869389 https://doi.org/10.1259/bjr.20170224
5. Ostryy pankreatit. Sbornik metodicheskikh materialov “Shkoly khirurgii ROKh”. Moscow; 2015. (in Russ.).
6. Bollen TL. Acute Pancreatitis. Radiol Clin North Am. 2012;50(3):429–445. PMID: 22560690 10.1016/j.rcl.2012.03.015
7. Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology. 2002;223(3):603–613. PMID: 12034923 https://doi.org/10.1148/radiol.2233010680
8. Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331–336. PMID: 2296641 https://doi.org/10.1148/radiology.174.2.2296641
9. Shyu JY, Sainani NI, Sahni VA, Chick JF, Chauhan NR, Conwell DL, et al. Necrotizing pancreatitis: diagnosis, imaging, and intervention. Radiographics. 2014;34(5):1218–1239. PMID: 25208277 https://doi.org/10.1148/rg.345130012
10. Bollen T, Hazewinkel M, Smithuis R. Acute Pancreatitis. 2012 Revised Atlanta Classification of Acute Pancreatitis. Available at: https://radiologyassistant.nl/abdomen/pancreas/acute-pancreatitis [Accessed April 14, 2022].
11. Leppäniemi A, Tolonen M, Tarasconi A, Segovia-Lohse H, Gamberini E, Kirkpatrick AW, et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg. 2019;14:27. PMID: 31210778 https://doi.org/10.1186/s13017-019-0247-0 eCollection 2019.
12. Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13(4Suppl2):e1–15. PMID: 24054878 https://doi.org/10.1016/j.pan.2013. 07.063
13. Working Party of the British Society of Gastroenterology. Association of Surgeons of Great Britain and Ireland; Pancreatic Society of Great Britain and Ireland; Association of Upper GI Surgeons of Great Britain and Ireland. UK guidelines for the management of acute pancreatitis. Gut. 2005;54(Suppl3):iii1–9. PMID: 15831893. https://doi.org/10.1136/gut.2004.057026
14. Yokoe M, Takada T, Mayumi T, Yoshida M, Isaji S, Wada K, et al. Japanese guidelines for the management of acute pancreatitis. J Hepatobiliary Pancreat Sci. 2015;22(6):405–432. PMID: 25973947 https://doi.org/10.1002/jhbp.259
15. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al.; Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis – 2012: revision of Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–111. PMID: 23100216 https://doi.org/10.1136/gutjnl-2012-302779
16. Marshall JC, Cook DJ, Christou NV, Bernard GR, Sprung CL, Sibbald WJ. Multiple organ dysfunction score: a reliable descriptor of complex clinical outcome. Crit Care Med. 1995;23(10):1638–1652. PMID: 7587228 https://doi.org/10.1097/00003246-199510000-00007
17. Ranson JH, Pasternack BS. Statistical methods for quantifying the severity of clinical acute pancreatitis. J Surg Res. 1977;22(2):79–91. PMID: 839764 https://doi.org/10.1016/0022-4804(77)90045-2
18. Galeev ShI, Topuzov ME, Rubtsov MA. Prognosis of Severe Acute Pancreatitis: Whether it is Enough of Criteria of Consensus “Atlanta 1992”? Preventive and Clinical Medicine. 2010;(1):102–105. (in Russ.)
19. van Dijk SM, Hallensleben NDL, van Santvoort HC, Fockens P, van Goor H, Bruno MJ, et al. Acute pancreatitis: recent advances through randomised trials. Gut. 2017;66(11):2024–2032. PMID: 28838972 https://doi.org/10.1136/gutjnl-2016-313595
20. Mamoshin Av, Borsukov Av, Muradyan Vf, Alyanov Al, Hatalov Rp. Miniinvasive Techniques of Acute Destructive Pancreatitis Diagnostic and Treatment. Scientific notes of Orel state university. 2015;4(67):368–374. (in Russ.)
Review
For citations:
Rudenko V.A., Kakaulina L.N., Verzakova I.V., Karamova I.M. Predicting the Severity of Acute Pancreatitis Using Ultrasound Markers and Clinical Scales. Russian Sklifosovsky Journal "Emergency Medical Care". 2022;11(2):274-279. https://doi.org/10.23934/2223-9022-2022-11-2-274-279
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