[Imaging of acute pancreatitis].

Abstract

The radiological management of acute pancreatitis is well codified. The positive diagnosis of acute pancreatitis is based on clinical and biological signs. However, imaging helps for in diagnosing severity and complications. The etiological diagnosis should strive to detect gallstones by an abdominal ultrasound to be performed within 24 hours of onset of symptoms. The severity is assessed at 48-72 hours per scanner after contrast media injection, according to the classification CTSI. It is important to avoid the two following pitfalls: realising the scanner too early, which could be falsely reassuring because necrosis of the pancreatic parenchyma appears at least 48 to 72 hours after onset of clinical signs, and dispense with ultrasound at 24 hours, because the gallstones are visible only in 50% of the scanner. Imaging helps to manage some complications of acute pancreatitis: in case of infectious complications, remember to perform a needle aspiration or percutaneous drainage of fluid collections; in case of haemorrhage from rupture of a false aneurysm, the treatment of choice is embolization for hemostasis under radiological guidance.