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Retrospective audit to assess the Imaging of Acute Pancreatitis
Poster Title: Retrospective audit to assess the Imaging of Acute Pancreatitis
Submitted on 29 Oct 2020
Author(s): Dr E Hannay, Dr C Robison, Miss S Ellis, Mr A Sharma
This poster was presented at BIR Annual Congress 2020 eposter
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Poster Information
Abstract: Background
Acute pancreatitis is generalised inflammation of the pancreas of varying severity. Pancreatic imaging is of use in cases of diagnostic uncertainty or severity assessment. Use of CT scanning is not advocated less than 72-96 hours from symptom onset2 as this may underestimate disease severity. This audit was performed to evaluate whether imaging is performed in accordance with Royal College of Radiologists guidelines in the surgical department.

Surgical admissions were searched by those coded with the term ‘acute pancreatitis’ over a six-month period. Case notes were reviewed retrospectively to identify those in which a CT was performed, the indication and reporting of prognostic factors as well as documentation of date of symptom onset.

65 patients were identified however only 20 underwent a CT scan. Only 25% were performed in the recommended timeframe of 72-96 hours. 95% reports commented on the presence of prognostic factors thus meeting the standard set. USS assessment of the biliary tree was performed in 41% cases within 24 hours of diagnosis.

Diagnostic uncertainty on presentation was the most common indication for CT imaging which explains why most were performed earlier than recommended in acute pancreatitis. The 95% standard was not met for USS within 24 hours due to CT-identification of gallstones or delayed imaging out of hours. Other areas for improvement include clinician education with regards CT imaging as well as the accurate documentation of symptom onset and on imaging requests.
Summary: Acute pancreatitis is a common cause of acute abdominal pain . It is largely a clinical diagnosis and early CT scanning (<72hrs) is against current guidance due to the risk of underestimating final disease severity. This audit looks at guidelines from the Royal College of Radiologists to assess out current practice at Wythenshawe hospital General Surgical Department. References: Context| Pancreatitis| Guidance| NICE. 2020. [accessed 27/10/20]

Gastroenterology. 1986 Aug;91(2):433-8. Bacterial contamination of pancreatic necrosis. A prospective clinical study. Beger HG, Bittner R, Block S, Büchler M

Imaging of Acute Pancreatitis | The Royal College of Radiologists. 2020.
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