There have been limited research studies done in Mongolia on clinical, laboratorial and computer tomographical diagnosis of acute pancreatitis.

 

Goal: 

Our study aims to examine clinical, laboratorial and CT symptoms diagnosis of acute pancreatitis, to diagnose the different types of acute pancreatitis, and to develop diagnostic criteria based on CT for differentiating among those types.

 

Objectives:

1. To study clinical symptoms of acute pancreatitis

2. To determine alpha amylase, ALAT, ASAT, and the amount of glucose.

3. To determine CT symptoms for the types of acute pancreatitis.

4. To develop diagnostic criteria based on CT for differentiating among those types

 

Materials and methods:

Over the years of 2006 to 2010, we have studied the CT symptoms of 59 patients diagnosed as having acute pancreatitis, and the clinical and laboratorial symptoms of 81 patients with the same disease, with the help of health facilities at Diagnostic Imaging Department of the “Achtan-elite” general hospital and “Friendship-Naran” diagnostics center. The scanners such as CT-W-4 type scanner of Japanese Toshiba Corporation, MSCT Presto (made in 2007 by Hitachi, Japan) and CT Max 640 type scanner of USA General Electric Corporation have been used for the diagnostics.

We successfully calculated the amount of alpha amylase, ALAT, and ASAT with colorimetric analysis. For this calculation,

we used amylase detector manufactured by German Human Firm. Sugar amount was measure by fermentive oxidization with dioxide-glucose. The acute pancreatitis inflammation, hemorrhage, necrosis and its various forms, and diagnosis have been proved by the brief x-ray imaging of the abdomen, x-ray with contrast injections for stomach and upper intestine, Ultrasonic, Celliacography, MRI, Cytology, Biopsy analysis and surgery. All the results were presented in commonly used statistical ways, taking into account possible calculation errors, and probabilities were checked with Student’s t-distribution.

Conclusion:

1. During acute pancreatitis, 56.8%±5.5 suffered from abdominal shooting pain, 28.3%±5.0 from stomach cramps, 79.0%±4.5 from diarrhea, 91.4%±3.1 from fever, and 56.8%±5.5 from abdominal hemorrhage.

2. The amount of alpha amylase in blood serum increased 6 times the amount of ASAT/ALAT 3 to 5 times.

3. By CT scanning, we have found more common CT symptoms such as sharp border edges of pancreas in swollen acute pancreatitis (in 69.2%±9.2 of the patients), entire and partial enlargement of the pancreas (in 73.1%±8.9 of the patients), fluid collection in the stomach rear room (in 61.1%±11.8 of the patients), in hemorrhage acute pancreatitis and uneven density reduction (in 66.7%±12.6 of the patients) and fluid collection in the stomach rear room (in 86.7%±9.1 of the patients), in necrosis type of acute pancreatitis respectively.

4. Shape, size, structure, density, borders, interaction with surrounding body organs, change in pancreas density after contrast injection and accumulated fluid in the rear stomach are identified as the main criteria to diagnose acute pancreatitis types and differentiate among them.

5. CT diagnostics of the acute pancreatitis types and differentiating among them are very crucial to select appropriate acute pancreatitis treatment on time.

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