Appropriate imaging in Acute pancreatitis
M.M.A. Rahman, S. Madenlidou, J. Reed
Quality improvement project with the aim to compare the current practice at a district general hospital to the UK and IAP (International Association of pancreatology) / APA (American pancreatic association) guidelines for radiological assessment of acute pancreatitis.
- Retrospective data were collected over ten months for patients admitted with acute pancreatitis who had a CT scan.
- Time interval from symptom onset and CT scan, indication for CT scan, CT report containing prognostic factors (necrosis, fat stranding, and presence of intraperitoneal fluid) and timing of ultrasound were obtained using electronic records and case notes.
- The target was to meet 95% of all standards.
- 28 patients were identified
- the median length of symptom onset to CT scan: 3.5 days (should be 3 - 4 days).
- 60.17% (n=17) of CT scans performed after 72-96 hours of symptom onset.
- 64.28% (n=18) of CT scans were requested for diagnostic uncertainty where initial amylase was <300 in 12 patients.
- Only 46.72% of CT reports contained all three radiological prognostic factors. 60.71% (n=17) of patients underwent US of GB <24 hours of diagnosis of acute pancreatitis.
- Targets were not met on any of the criteria.
- Standards outlined in the UK and IAP/APA guidelines were not met in the current practice.
- Raising awareness by providing departmental teaching of audit findings to surgical teams and radiologists can improve outcomes.
- Further audit is in progress