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Persistent SIRS and acute fluid collections are associated with increased CT scanning in acute interstitial pancreatitis
Authors:Ayesha Kamal  Mahya Faghih  Robert A. Moran  Elham Afghani  Amitasha Sinha  Nasim Parsa
Affiliation:Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
Abstract:Background: The use of computed tomography (CT) in acute pancreatitis (AP) continues to increase in parallel with the increasing use of diagnostic imaging in clinical medicine.

Aim: To determine the factors associated with obtaining >1 CT scan in acute interstitial pancreatitis (AIP).

Methods: Demographic and clinical data of all adult patients admitted between 1/2010 and 1/2015 with AP (AP) were evaluated. Only patients with a CT severity index (CTSI)?≤?3 on a CT obtained within 48?h of presentation were included.

Results: A total of 229 patients were included, of whom 206 (90%) had a single CT and 23 (10%) had >1 CT during the first week of hospitalization. Patients undergoing >1 CT had significantly higher rates of acute fluid collection (AFC), persistent SIRS, opioid use ≥4 days, and persistent organ failure compared to those undergoing 1 CT (p?p?=?.01) and an AFC on initial CT (OR?=?3.5, 95% CI 1.4–9, p?=?.009) were independently associated with obtaining >1 CT.

Conclusion: An AFC on initial CT and persistent SIRS are associated with increased CT imaging in AIP patients. However, these additional CT scans did not change clinical management.
Keywords:Acute pancreatitis  CT scans  persistent SIRS  acute fluid collection
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