caa a22 4500 606171398 CHVBK 20210128100722.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10140-014-1266-5 doi (NATIONALLICENCE)springer-10.1007/s10140-014-1266-5 Does early ED CT scanning of afebrile patients with first episodes of acute pancreatitis ever change management? [Elektronische Daten] [Robert Dachs, Luke Sullivan, Preshanthini Shanmugathasan] Rising utilization of computed tomography (CT) imaging early in the course of acute pancreatitis (AP) has been recently reported. However, radiographic demonstration of the degree of necrosis or the presence of complications is not fully apparent within the first days of an acute attack. The objective of this study was to examine if CT scanning early in the course of disease (<48h of symptoms) in afebrile patients with an emergency department (ED) diagnosis of first episode of AP revealed any unanticipated pathology that altered clinical management. A retrospective chart review of all adult patients with a first episode of AP without fever admitted to the medical ward through the ED of our community hospital from January 1, 2011 to May 31, 2012 was performed. In cases in which CT scans were performed, the record was reviewed to determine if any unexpected findings were uncovered or if patient care was altered by the CT report. Two hundred forty-eight patients were admitted with an ED diagnosis of AP; 26.2% (n = 65) met inclusion criteria; 70.8% (n = 46) received a CT scan within 48h of symptom onset. No patient that underwent CT scanning had an unexpected finding (95% CI, 0.923-1.0). Our results demonstrate that afebrile patients with first episodes of AP do not benefit from early abdominal CT imaging. These results support the ACR Appropriateness Criteria recommendation that CT is not indicated in the first 48h after symptom onset in unequivocal cases of AP. American Society of Emergency Radiology, 2014 Pancreatitis nationallicence Acute pancreatitis nationallicence CT scan nationallicence Radiology nationallicence Dachs Robert Department of Emergency Medicine, Ellis Hospital, 1011 Nott Street, 12308, Schenectady, NY, USA aut Sullivan Luke Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA aut Shanmugathasan Preshanthini Ellis Family Medicine Residency, Ellis Hospital, Schenectady, NY, USA aut Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 239-243 1070-3004 22:3<239 2015 22 10140 https://doi.org/10.1007/s10140-014-1266-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10140-014-1266-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Dachs Robert Department of Emergency Medicine, Ellis Hospital, 1011 Nott Street, 12308, Schenectady, NY, USA aut NATIONALLICENCE 700 1- Sullivan Luke Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Shanmugathasan Preshanthini Ellis Family Medicine Residency, Ellis Hospital, Schenectady, NY, USA aut NATIONALLICENCE 773 0- Emergency Radiology Springer Berlin Heidelberg 22/3(2015-06-01), 239-243 1070-3004 22:3<239 2015 22 10140