How is acute pancreatitis diagnosed?
The diagnosis of acute pancreatitis can be challenging because the signs and symptoms of other medical conditions can mimic those of pancreatitis. The diagnosis is usually based upon careful consideration of a person's medical history, the
signs and symptoms noted during a physical examination, and the results of specific diagnostic tests. Once a diagnosis of acute pancreatitis is made, additional tests are used to determine the underlying cause. This step ensures that a person will receive the correct treatment to prevent pancreatitis from recurring.
Contrast-enhanced computed tomography (CECT) is the imaging criterion standard for the evaluation of acute pancreatitis and its complications. Using non–contrast-enhanced CT, clinicians can establish the diagnosis and demonstrate fluid collections but cannot evaluate for pancreatic necrosis or vascular complications. CECT allows complete visualization of the pancreas and retroperitoneum, even in the setting of ileus or overlying bandages from a recent surgical procedure. CECT can help detect almost all major abdominal complications of acute pancreatitis, such as fluid collections, pseudocysts, abscesses, venous thrombosis, and pseudoaneurysms.
Additional tests also help predict the likely course of pancreatitis over time. This step is important because in a small percentage of people with acute pancreatitis, the condition will progress to a more serious condition called necrotizing pancreatitis. If tests suggest that necrotizing pancreatitis is likely, early intensive medical treatment may help improve the prognosis.