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*   CT Pancreatitis
*   http://www.radreport.org/template/0000078	


Type: Reporting template
Language: English (en)
Modified date: 2012-07-16
Creator: Heilbrun ME, et al.
Contributor: Hong Y [coder]
Contributor: Kahn CE Jr [editor]
Contributor: Society for Computed Body Tomography and Magnetic Resonance (SCBTMR)
	
This file is part of the "RSNA Radiology Reporting Templates."

The RSNA Radiology Reporting Templates are licensed without charge under
the RSNA's license agreement (the "License"); you may not use this file
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Unless required by applicable law or agreed to in writing, software
distributed under the License is distributed on an "AS IS" BASIS, WITHOUT
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Copyright (c) 2013, Radiological Society of North America, Inc. (RSNA)
ALL RIGHTS RESERVED

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CT ABDOMEN [AND PELVIS] WITHOUT AND WITH CONTRAST: PANCREATITIS PROTOCOL 
CLINICAL INDICATION: [Pancreatitis]. {If available, describe the time from onset of disease, eg <1 week, > 4 weeks, etc)
COMPARISON: [<date> | None*].
TECHNIQUE: {Institution specific, with verbiage regarding post-processing per institution protocol as necessary for billing and coding purposes.}
Unenhanced and multi-phasic contrast enhanced imaging of the abdomen [and pelvis]. Scan phases: []
{Post-processing description}
IV contrast: [# ml] [<Contrast agent and concentration>] 
Oral contrast: [None | xxx Volumen]
CT radiation dose: {Dose  CTDLP: xxx  mGy*cm, for example.}
 
OBSERVATIONS:
Pancreatitis: [Present*|Absent]
{If pancreatitis is absent insert phrase to indicate that no CT evidence of pancreatitis or its complications is identified, and revert to normal CT template.  If pancreatitis is present, continue with this template for documentation of the extent of disease}
Extent of disease: [Diffuse enlargement* |Focal enlargement]
{If focal describe site of involvement: [Uncinate process| Head| Neck| Body| Tail]]
Parenchymal enhancement: [Homogeneous*| Non-homogeneous]
Necrosis:  [Absent*| Present with [<30% | 30-50%| >50%] involvement| Indeterminate]
{If necrosis present, describe site of involvement: [Uncinate process| Head| Neck| Body| Tail]]
Pancreatic/Peripancreatic fluid collections: [Present*|Absent]
Location: 
Intrapancreatic: [Yes| No] {if yes, use features below to characterize}
Extrapancreatic: [Yes| No] {if yes, use features below to characterize}
Characteristics: [Homogeneous| Non-homogeneous] {if non-homogeneous comment on the attenuation, fat, soft tissue, fluid, etc.}
Well demarcated wall: [Yes| No] {describe thickness, completeness, septations, etc}
Extraluminal gas or Air/fluid level: [None*| Yes {describe}] {presence of gas implies infected collection, may be necessary to confirm with FNA, for Gram stain/culture.}
Size & Location; [# x # cm] {free text} 
 
Related extrapancreatic findings: 
Gallstones: [No*|Yes]
Extrahepatic biliary dilatation: [No*|Yes]
Venous thrombosis [No*| Yes] {if yes describe the specific vessels involved: [Portal vein |Superior mesenteric vein | Splenic vein]}
Varices: [No*|Yes] {if yes, describe}
Arterial (pseudo)aneurysm: [No*|Yes] {free text location, size}
Pleural effusions: [No*|Yes]
Ascites: [No*|Yes]
Inflammatory involvement of [stomach| duodenum| jejunum| colon {where} | right kidney| left kidney]

IMPRESSION:
Acute pancreatitis.
[Interstitial edematous pancreatitis* | Necrotizing pancreatitis] 
{if necrotizing pancreatitis, describe location [Pancreatic necrosis with peripancreatic necrosis*| Pancreatic necrosis alone| Peripancreatic necrosis alone]}  
Fluid collections: [None*| Pancreatic and peripancreatic| Pancreatic alone| Peripancreatic alone].  {If gas bubbles/air-fluid levels noted comment specifically, as this indicates infected fluid collections}
**
{alternative verbiage in centers using most current Atlanta Classification to characterize the peripancreatic fluid collections:
< 4 weeks after onset of pancreatitis:  [Acute necrotic collection (ANC)| Acute peripancreatic fluid collection (APFC)]
> 4 weeks after onset of pancreatitis: [Panceatic pseudocyst| Walled off necrosis (WON)]