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• W3022844083 abstract "The comparative study of CT scan and MRI by Arvanitakis et al.1Arvanitakis M. Delhaye M. Maertelaere V.D. Bali M. Winant C. et al.Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis.Gastroenterology. 2004; 126: 715-723Abstract Full Text Full Text PDF PubMed Scopus (261) Google Scholar in the assessment of acute pancreatitis was interesting. However, pancreatic duct disruption occurs in up to 30% of patients with acute necrotising pancreatitis.2Uomo G. Molino D. Visconti M. Ragozzino A. Manes G. Rabitti P.G. The incidence of main pancreatic duct disruption in severe biliary pancreatitis.Am J Surg. 1998; 176: 49-52Abstract Full Text Full Text PDF PubMed Scopus (94) Google Scholar Most of these disruptions heal with the resolution of ongoing pancreatitis. The significance of the presence of duct disruption and the early course of pancreatitis and need for surgery is controversial.2Uomo G. Molino D. Visconti M. Ragozzino A. Manes G. Rabitti P.G. The incidence of main pancreatic duct disruption in severe biliary pancreatitis.Am J Surg. 1998; 176: 49-52Abstract Full Text Full Text PDF PubMed Scopus (94) Google Scholar, 3Neoptolemos J.P. London N.J. Carr-Locke D.L. Assessment of main pancreatic duct integrity by endoscopic retrograde pancreatography in patients with acute pancreatitis.Br J Surg. 1993; 80: 94-99Crossref Scopus (132) Google Scholar Delineation of the pancreatic duct is probably only necessary when persistent duct leakage, after the initial active disease has settled, presents as a nonresolving pseudocyst or pancreatic fistula needing surgical or endoscopic intervention. The recent IAP guidelines on surgery in acute pancreatitis also make no mention regarding duct disruptions.4Uhl W. Warshaw A. Imrie C. Bassi C. McKay C.J. et al.IAP guidelines for the surgical management of acute pancreatitis.Pancreatology. 2002; 2: 565-573Abstract Full Text PDF PubMed Scopus (720) Google Scholar Do the authors feel that early detection of ductal disruption in acute pancreatitis have enough benefit to overcome the limitations of MR imaging in terms of cost, availability, and patient discomfort? ReplyGastroenterologyVol. 127Issue 4PreviewFirst, we would like to thank the authors for this interesting comment. It is true that there is still limited data concerning the outcome of pancreatic duct disruption in patients with acute pancreatitis, with 2 retrospective studies and 1 prospective study published until now.1–3 It is probably the reason that it is not mentioned in the IAP guidelines on surgery in acute pancreatitis published in 2002.4 Full-Text PDF" @default.
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• W3022844083 title "Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis" @default.
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