Title

ACR Appropriateness Criteria(R) Acute Pancreatitis

UMMS Affiliation

Department of Radiology

Publication Date

2019-11-01

Document Type

Article

Disciplines

Digestive System Diseases | Health Services Administration | Radiology

Abstract

Acute pancreatitis (AP) is divided into two types: interstitial edematous and necrotizing. AP severity is classified clinically into mild, moderately severe, and severe, depending on the presence and persistence of organ failure and local or systemic complications. The revised Atlanta classification divides the clinical course of AP into an early (first week) and late phase (after first week) and the clinical phase determines the role of imaging. Imaging has a limited role in the early phase. In the early phase with typical presentations of AP, ultrasound is usually the only appropriate modality and is used for the detection of gallstones. CT and MRI are appropriate in the early phase in equivocal presentations. In the late phase (or at least 48-72 hours after presentation), CT and MRI play a primary role in the imaging of patients with AP for evaluation of etiology, complications, extent of disease, intervention, and follow-up; CT is particularly useful in patients with suspected acute hemorrhage. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Keywords

AUC, Acute pancreatitis, Appropriate Use Criteria, Appropriateness Criteria, Atlanta Classification, Epigastric pain, Interstitial edematous pancreatitis, Necrotizing pancreatitis, Peripancreatic fluid collection

DOI of Published Version

10.1016/j.jacr.2019.05.017

Source

J Am Coll Radiol. 2019 Nov;16(11S):S316-S330. doi: 10.1016/j.jacr.2019.05.017. Link to article on publisher's site

Journal/Book/Conference Title

Journal of the American College of Radiology : JACR

Comments

Full author list omitted for brevity. For the full list of authors, see article.

Related Resources

Link to Article in PubMed

PubMed ID

31685100

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