Role of computed tomography in acute pancreatitis and its complications among age groups.

OBJECTIVE: To determine value of CT scan in diagnosis of acute pancreatitis, its complications and to correlate with severity among different age groups. METHODS: The study was carried out from August 2001 to August 2002 at the Radiology Department, Aga Khan University Hospital. A total of 40 patients (33 male and 7 female) with age range from 16-71 years were divided in three groups. Group I was less than 40 years (12 patients), Group II was between 40-60 years (17 patients), and Group III was more than 60 years (11 patients). CT scans were assessed for pancreatic necrosis and its complications. CT Severity Index (CTSI) was calculated according to Balthazar's method. RESULTS: In 17 patients with mild pancreatitis, 5 had necrosis involving one-third of pancreas. In 13 patients with severe pancreatitis, 8 had necrosis involving more than half of the pancreas and 5 had necrosis involving half of the pancreas. No significant correlation was demonstrated between moderate pancreatitis and degree of necrosis. Thirty patients had complications, 8 had mild CTSI, 9 had moderate CTSI and 13 patients had severe CTSI. CONCLUSION: The study demonstrated a relationship between CTSI and severity of pancreatic damage and incidence of complications.

Ultrasound in the diagnosis and management of intrauterine growth retardation.

OBJECTIVE: To evaluate the value of ultrasound in the diagnosis and management strategies of intrauterine growth retardation. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: Radiology Department, Aga Khan University Hospital, Karachi, from April 1998 to August 1999. PATIENTS AND METHODS: The study population comprised of 206 subjects evaluated for suspected intrauterine growth retardation. Grey scale as well as Doppler ultrasound findings were evaluated and compared against post-natal outcome. RESULTS: One hundred and eight out of 206 subjects showed positive imaging results with 40 false positive and 20 false negative subjects. The sensitivity, specificity, positive predictive and negative predictive values were 77.8%, 66.1%, 55.6%, and 45.1% respectively. Forty subjects showed false positive results on imaging (low biophysical profile score and Grey scale biometry discrepancy) while 20 of the subjects showed false negative results (normal on US imaging) when compared with postnatal neonatal body weight criteria. Twenty-two subjects had oligohydramnios with amniotic fluid index below 5 percentile for their respective gestational ages (20%) out of 108. CONCLUSION: Obstetric and Doppler ultrasound is an accurate method for diagnosis and management of fetal growth retardation.