What is the role of CT in pancreatitis?
- CT is indicated if the diagnosis is equivocal, to rule out alternative intra-abdominal catastrophes
- In acute severe pancreatitis, CT is used to detect and stage regional complications such as pancreatic necrosis:
- Should be performed in those with new or persisting organ failure
- If the diagnosis is clear, it may be appropriate to delay CT imaging for at least 48–72 h after onset of symptoms because the full extent of pancreatic necrosis cannot be determined until this time
- Patients with SAP often require multiple contrast-enhanced CT scans to assess progress and screen for complications
- The risk of contrast nephropathy should be considered in patients who have already had septic, hypoxaemic, and ischaemic insults to the kidneys.