ACR Appropriateness Criteria® Acute Pancreatitis.

Journal Article (Journal Article;Review)

Acute pancreatitis (AP) is divided into two types: interstitial edematous and necrotizing. AP severity is classified clinically into mild, moderately severe, and severe, depending on the presence and persistence of organ failure and local or systemic complications. The revised Atlanta classification divides the clinical course of AP into an early (first week) and late phase (after first week) and the clinical phase determines the role of imaging. Imaging has a limited role in the early phase. In the early phase with typical presentations of AP, ultrasound is usually the only appropriate modality and is used for the detection of gallstones. CT and MRI are appropriate in the early phase in equivocal presentations. In the late phase (or at least 48-72 hours after presentation), CT and MRI play a primary role in the imaging of patients with AP for evaluation of etiology, complications, extent of disease, intervention, and follow-up; CT is particularly useful in patients with suspected acute hemorrhage. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Full Text

Duke Authors

Cited Authors

  • Expert Panel on Gastrointestinal Imaging, ; Porter, KK; Zaheer, A; Kamel, IR; Horowitz, JM; Arif-Tiwari, H; Bartel, TB; Bashir, MR; Camacho, MA; Cash, BD; Chernyak, V; Goldstein, A; Grajo, JR; Gupta, S; Hindman, NM; Kamaya, A; McNamara, MM; Carucci, LR

Published Date

  • November 2019

Published In

Volume / Issue

  • 16 / 11S

Start / End Page

  • S316 - S330

PubMed ID

  • 31685100

Electronic International Standard Serial Number (EISSN)

  • 1558-349X

Digital Object Identifier (DOI)

  • 10.1016/j.jacr.2019.05.017


  • eng

Conference Location

  • United States