IMPORTANCE OF NON-ALCOHOLIC FATTY STEATOSIS IN PREDICTING SEVERITY OF ACUTE PANCREATITIS

Abstract

OBJECTIVE

The purpose of this study is to establish and explore association of acute pancreatitis severity with hepatic steatosis.

METHODOLOGY

This retrospective cross-sectional study was carried out at Shifa International Hospital, Radiology Department. Two radiologists reviewed the abdominal CT images of 129 patients (from January 2020 to December 2022) with acute pancreatitis. Diagnosis was based upon clinical presentation, elevated serum amylase / lipase levels >1000, and findings reported on CT. Fatty liver (FL) was determined by using liver- spleen index of less than or equal to 1, i.e. mean CT Hounsfield units (HU) of hepatic and splenic attenuation values. After computation, the modified CT severity index was categorized as: mild (0–2), moderate (4-6), and severe (8–10).

RESULTS

Of 129 subjects, ages ranging from 9 to 84, 55 (42.6%) were female and 74 (57.4%) were male, 38 (29.5%) did not have fatty liver, while 91 (70%) did. 56 patients (43%) had moderate CT severity index of acute pancreatitis, 40 cases (43.9%) of these cases had fatty liver, with a significant p-value of 0.031. In particular, walled off/liquefactive necrosis and pancreatic collections occurred commonly in the FL group's post-pancreatitis sequelae. Furthermore, the frequency of extra-pancreatic complications was higher in the FL group (p-value = 0.004).

CONCLUSION

In summary, MDCT can be used to accurately identify FL and, if it is present, can act as a prognostic factor in categorizing the severeness of acute pancreatitis, which may assist doctors in forecasting the disease's course and outcome.

Keywords: Acute pancreatitis, Nonalcoholic fatty liver disease, modified CT severity index for acute pancreatitis.