The pivotal role of emergency imaging in setting of acute pancreatitis

Abstract Acute pancreatitis (AP) is a common and potentially life-threatening inflammatory disorder of the pancreas, often linked to multi-organ failure and systemic complications. This review examines the evolving epidemiology, clinical presentation, and imaging considerations of AP, including the differentiation of interstitial edematous pancreatitis (IEP) from necrotizing pancreatitis (NP). Imaging, particularly computed tomography (CT), plays a critical role in diagnosing and grading AP, identifying complications such as pancreatic and peripancreatic fluid collections, vascular issues, and necrosis. The review discusses the phases of AP, grading systems, and the latest imaging protocols to assess pancreatic necrosis and other associated complications. Radiologic evaluation helps guide management decisions, including the “step-up” approach to managing necrotizing pancreatitis. Despite advancements, complications such as infected necrotic collections and vascular thrombosis continue to present challenges, necessitating a multidisciplinary approach. Ultimately, imaging remains essential for accurate diagnosis, prognostication, and the management of acute pancreatitis.