Role of CT Scan in Acute Pancreatitis: When is it Indicated and What Information can be Obtained?

The routine use of CT imaging is not warranted as most cases of acute pancreatitis (AP) are mild and uncomplicated. The primary role of imaging during the initial presentation of AP is to ascertain the diagnosis and detect pancreatic and/or extrapancreatic complications. Practice guidelines recommend against the use of early CT imaging. A predictive model for the diagnosis of AP aimed to decrease the use of imaging was developed using the following predictors: number of prior AP episodes; history of cholelithiasis; no abdominal surgery (prior two months); time elapsed from symptom onset; pain localized to epigastrium; progressively worsening severity; severity level at presentation; and lipase levels five or more times the upper limit of normal. CT imaging is associated with multiple risks. CT imaging should only be pursued when the results will impact patient management as this will also help reduce unnecessary exposure to ionizing radiation.