Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis

Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patient...

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Main Authors: Markus Nistal, Malai Zoltani, Ansgar W. Lohse, Nicola Di Daniele, Manfredi Tesauro, Andrea Pace
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2014/438697
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author Markus Nistal
Malai Zoltani
Ansgar W. Lohse
Nicola Di Daniele
Manfredi Tesauro
Andrea Pace
author_facet Markus Nistal
Malai Zoltani
Ansgar W. Lohse
Nicola Di Daniele
Manfredi Tesauro
Andrea Pace
author_sort Markus Nistal
collection DOAJ
description Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases. 69 out of 283 patients (24,3%) had CRP >150 mg/dl within 48 hours after admission. 32 of them had SAP. The CRP cutoff of 150 mg/L had a sensitivity of 80% and a specificity of 65%. The positive predictive value for SAP in patients beyond the cutoff is 46.4%. The negative predictive value for SAP in patients below the cutoff was 89.5%. Our results support the opinion that an early CE-CT is usually not indicated. CRP helps to assess the course of AP; levels below 150 mg/dl between the first 48 h indicate a mild course in most of the cases.
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institution Kabale University
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publishDate 2014-01-01
publisher Wiley
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series Gastroenterology Research and Practice
spelling doaj-art-1ae6895292b446d0b3084f08beed3ec22025-02-03T01:01:59ZengWileyGastroenterology Research and Practice1687-61211687-630X2014-01-01201410.1155/2014/438697438697Analysis of the Power of Common Diagnostic Tools in the Management of Acute PancreatitisMarkus Nistal0Malai Zoltani1Ansgar W. Lohse2Nicola Di Daniele3Manfredi Tesauro4Andrea Pace5Sozialstiftung Bamberg-Medizinische Klinik II, 96049 Bamberg, GermanyMedizinische Klinik I, Universitaetsklinikum Hamburg-Eppendorf, 20246 Hamburg, GermanyMedizinische Klinik I, Universitaetsklinikum Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Internal Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, ItalyDepartment of Internal Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, ItalyMedizinische Klinik I, Universitaetsklinikum Hamburg-Eppendorf, 20246 Hamburg, GermanyAcute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases. 69 out of 283 patients (24,3%) had CRP >150 mg/dl within 48 hours after admission. 32 of them had SAP. The CRP cutoff of 150 mg/L had a sensitivity of 80% and a specificity of 65%. The positive predictive value for SAP in patients beyond the cutoff is 46.4%. The negative predictive value for SAP in patients below the cutoff was 89.5%. Our results support the opinion that an early CE-CT is usually not indicated. CRP helps to assess the course of AP; levels below 150 mg/dl between the first 48 h indicate a mild course in most of the cases.http://dx.doi.org/10.1155/2014/438697
spellingShingle Markus Nistal
Malai Zoltani
Ansgar W. Lohse
Nicola Di Daniele
Manfredi Tesauro
Andrea Pace
Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis
Gastroenterology Research and Practice
title Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis
title_full Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis
title_fullStr Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis
title_full_unstemmed Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis
title_short Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis
title_sort analysis of the power of common diagnostic tools in the management of acute pancreatitis
url http://dx.doi.org/10.1155/2014/438697
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