Abstract:

Acute severe pancreatitis is the most severe disease in urgent abdominal surgery In these conditions - diagnosis and treatment of this group of patients remains a high priority issue of urgent surgery and intensive care therapy It is extremely important to estimate severity of local changes and general conditions of patient in order to draw up efficient disease management and forecast the outcome of the disease. It can be done by the use of different scoring systems of severity: J.H.C. Ranson, Glasgow (Imrie), SOFA, APACHE I or II, SAPS, MODS and others. Instrumental methods of investigation are used to examine scale and type of disease of pancreas, retroperitoneum and abdominal: laparoscopy, ultrasonography, computed tomography (CT), magnetic resonance imaging. It is generally recognized that the most informative methods of diagnosis of acute severe pancreatitis and its complications are ultrasound diagnostics and computed tomography In 2008 in Mumbai the Acute Pancreatitis Classification Working Group identified two types of classification - clinical and morphological, the last is based on beam diagnostics. Clinical classification is used during the early stage of disease (within the first week of acute pancreatitis manifestation), morphological classification is applicable to the subsequent stage (usually after the first week of illness). This allows radiologists to describe the «morphology» while clinicians include the results of the examination into the overall clinical picture and draw up the plan of appropriate treatment.