急性胰腺炎经腹部超声检查:横断面研究

M. Gyawali, A. Shrestha, P. Sharma, B. Shrestha, S. Bhattarai
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摘要

背景:急性胰腺炎(AP)是引起急性腹痛的常见原因。腹部对比增强计算机断层扫描(CECT)是急性胰腺炎的首选成像方法。超声检查可以作为评估胰腺的第一种、容易获得的成像方式。本研究旨在探讨急性胰腺炎患者经腹超声心动图的表现。它还将比较急性胰腺炎的USG表现和CT表现。方法:一项基于医院的横断面前瞻性研究,包括连续55例急性胰腺炎患者,研究时间为15个月。研究并比较急性胰腺炎的经腹USG表现和CECT表现。数据分析采用SPSS version 20, p值≤0.05为显著性。结果:胰腺超声显像率仅为69%。84.2%的急性胰腺炎患者在超声检查中发现胰腺和/或胰腺外,而CECT腹部检查的这一比例为98.2%。USG无法证实75%的轻度急性胰腺炎患者的发现。结论:经腹超声对胰腺炎的诊断效果优于CECT。它在检测轻度急性胰腺病例中的作用有限。尽管如此,超声检查可以更好地发现病因,如胆结石,以及评估额外的胰液收集,如腹水和胸腔积液。USG很容易获得,便宜,无创,可以作为急性胰腺炎的初步诊断工具,并排除其他原因的急腹症。
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Trans abdominal Ultrasonography in Acute Pancreatitis: a cross sectional study
BACKGROUND: Acute pancreatitis (AP) is a common cause of acute pain abdomen. Contrast-enhanced Computed Tomography (CECT) of the abdomen is the imaging method of choice in acute pancreatitis. Ultrasonography can be used as the first, easily available imaging modality for the assessment of the pancreas. This study aims to study the transabdominal USG findings in patients with acute pancreatitis. It will also compare USG findings with CT findings in acute pancreatitis. METHODS: A hospital-based cross-sectional, prospective study comprising of consecutive 55 patients with acute pancreatitis was conducted over a study period of 15 months. Trans abdominal USG findings and CECT abdominal findings in acute pancreatitis were studied and compared. Data analysis was done using SPSS version 20 and a p-value of ≤0.05 was considered significant. RESULTS: Pancreas was visualized by USG in only 69%. Ultrasonography had some pancreatic and/or extrapancreatic findings in patients with acute pancreatitis in 84.2% of patients in whom the pancreas was visualized, whereas, it was 98.2% by CECT abdomen. USG was unable to demonstrate findings in 75% of patients with mild acute pancreatitis. CONCLUSION: Transabdominal ultrasonography detection of pancreatitis was inferior to the CECT. It had a limited role in detecting mild acute pancreatic cases. Nonetheless, detection of etiological factor such as gallstones, and assessment of extra pancreatic fluid collection like ascites and pleural effusion were better visualised with ultrasound. USG is readily available, cheap, noninvasive, and can be utilized as an initial diagnostic tool for acute pancreatitis and ruling out other causes of acute abdomen.
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