Role of USG and Contrast Enhanced Computed Tomography in Diagnosis of the Local Complications of Acute Pancreatitis

Abstract Introduction: Acute pancreatitis (AP) is a common gastrointestinal emergency, often complicated by local manifestations such as pancreatic necrosis, pseudocysts, fluid collections, and abscesses. Timely and accurate detection of these complications is crucial for patient management and prognosis. Imaging modalities such as ultrasonography (USG) and contrast-enhanced computed tomography (CECT) play a pivotal role in diagnosis. Aims: To evaluate and compare the effectiveness of USG and CECT in identifying the local complications of acute pancreatitis. Materials and Methods: The present study is a cross-sectional study conducted at the Department of Radiodiagnosis, Nil Ratan Sircar Medical College, Kolkata, from January 2020 to June 2021. It included a total of 50 middle-aged patients with clinically suspected or biochemically/radiologically confirmed acute pancreatitis, who were referred for abdominal ultrasonography (USG) and contrast-enhanced computed tomography (CECT) from the emergency or outpatient departments. USG and CECT were performed on all patients, and the findings were recorded in a pre-designed proforma and subsequently analyzed using appropriate statistical methods. Results: In our study of 50 acute pancreatitis patients, USG showed pancreatic enlargement (head 30%, body 30%, tail 24%), heterogeneous echo texture (72%), peripancreatic collections (54%), pseudo cysts (26%), walled-off necrosis (8%), and portal vein thrombus (6%). CECT detected peripancreatic fat stranding (88%), pancreatic enlargement (head 46%, body 58%, tail 48%), fluid collections, pseudo cysts (28–30%), walled-off necrosis (6–12%), and venous thrombosis (portal 12%, splenic 4%). Overall, CT was superior in detecting pancreatic enlargement, localizing pseudo cysts, necrosisand identifying venous thrombosis or other vascular complication. Conclusion: While USG remains a useful initial, non-invasive, bedside tool for screening local complications of acute pancreatitis, CECT is the imaging modality of choice for comprehensive evaluation, accurate diagnosis, and guiding therapeutic decisions. Integration of both modalities enhances diagnostic confidence and optimizes patient care.