1. SPECTRUM OF PANCREATITIS
ABSTRACT NO-145

2. LEARNING OBJECTIVES
To Define acute pancreatitis phases and its types [interstitial edematous and necrotizing] and naming the various fluid collections [APFC,PSEUDOCYST,ANC,WON] as defined by the REVISED NEW ATLANTA CLASSIFICATION.

3. The revised Atlanta classification distinguishes an early phase (1st week) in which clinical parameters determine treatment from a later phase (after the 1st week) in which treatment is determined on the basis of clinical parameters and morphologic criteria defined by CT.

4. Severe acute pancreatitis is defined in the first phase as organ failure lasting more than 48 hours or death; and during the second phase as persistent organ failure, death, or complications resulting from acute pancreatitis

5. TYPE OF PANCREATITIS Interstitial edematous pancreatitis
Acute necrotizing pancreatitis
1.parenchymal necrosis
2.peripancreatic necrosis
3.combined type with or with out infection

6. TYPES OF PANCREATITIS – FLUID COLLECTION
INTERSTITIAL EDEMATOUS PANCREATITIS
STERILE/INFECTED
<4 WEEKS-ACUTE PERI PANCREATIC FLUID COLLECTION
> 4 WEEKS –PANCREATIC PSEUDO CYST

7. NECROTIZING TYPE NECROTIZING PANCREATITIS
< 4 WEEKS-ACUTE NECROTIC COLECTION
STERILE/INFECTED
> 4 WEEKS-WALLED OFF NECROSIS

8. Intraparenchymal fluid collections due to pancreatitis are referred to as ANCs or WONs, not as pseudo cysts.
Pseudo cysts rarely become infected or require intervention For sterile ANC or WON, any need for drainage is based on the clinical information; infected ANCs or WONs usually require intervention

9. INTERSTITIAL EDEMATOUS PANCREATITIS

10. INTERSTITIAL EDEMATOUS PANCREATITIS

11. INTERSTITIAL EDEMATOUS PANCREATITIS

12. ACUTE NECROTIZING PANCREATITIS

13. PANCREATIC PARENCHYMAL NECROSIS

14. PANCREATIC PARENCHYMAL NECROSIS

15. PANCREATIC PARENCHYMAL NECROSIS

16. PERI PANCREATIC NECROSIS

17. PERI PANCREATIC NECROSIS

18. COMBINED TYPE-NECROSIS

19. COMBINED TYPE-NECROSIS

20. ACUTE NECROTIZING-INFECTIOUS

21. ACUTE PERI PANCREATIC FLUID COLLECTION

22. PANCREATIC PSEUDO CYST

23. PANCREATIC PSEUDO CYST

24. ACUTE NECROTIC COLLECTION

25. ACUTE NECROTIC COLLECTION

26. WALLED OFF NECROSIS

27. WALLED OFF NECROSIS

28. MULTI COMPARTMENTAL COLLECTION
LEFT PLEURAL COLLECTION
SUB CAPSULAR RENAL PSEUDO COLLECTION

29. MULTI COMPARTMENTAL COLLECTION
LOCULATED SUB HEPATIC
LEFT PARACOLIC GUTTER

30. MULTI COMPARTMENTAL COLLECTION
LESSER SAC
PELVIC

31. MULTI COMPARTMENTAL COLLECTION

33. TAKE HOME MSG Identification of necrosis & %
Associated findings & complications
IEP/ANP
Intra pancreatic pseudocyst
Pancreatic abscess
Acute After 4 weeks
Pan / Peri panNecrosis walled of Pan / peri panNecrosis
Fluid collection Pseudocyst
Infected - Air bubble/ pus aspiration – clinical sepsis
CT severity index - prognostication

34. THANK YOU