Abstract:
Background. Emphysematous necrotizing pancreatitis (ENP) is a severe form of acute
pancreatitis, characterized by infected necrosis and accumulation of intra- and
peripancreatic gas. Early diagnosis via computed tomography (CT) is essential for evaluating
inflammation extent and guiding therapy.
Objective(s). To evaluate the performance of computed tomography in diagnosing
emphysematous necrotizing pancreatitis and to compare its effectiveness with other
imaging methods used in clinical practice.
Materials and methods. A retrospective observational study was conducted, based on CT
image analysis and clinical data of patients diagnosed with emphysematous necrotizing
pancreatitis. Methods included contrast-enhanced CT, abdominal ultrasound, and magnetic
resonance imaging. Necrosis, gas, fluid collections, and inflammation extent were analyzed.
Results. CT is the gold standard in imaging evaluation of emphysematous necrotizing
pancreatitis because it rapidly and accurately detects inhomogeneous parenchymal
necrosis, intrapancreatic and peripancreatic fluid collections, and air in infectious foci.
Abdominal ultrasound is limited by intestinal gas and reverberation artifacts, while
magnetic resonance imaging, though offering excellent tissue resolution, is less accessible.
Contrast-enhanced CT provides essential data for assessing inflammation severity, staging
necrosis, and identifying complications. Recent studies confirm contrast-enhanced CT as the
reference standard in ENP management.
Conclusion(s). Early and accurate diagnosis of emphysematous necrotizing pancreatitis by
contrast-enhanced CT is an essential element in assessing the extent of necrosis and
associated complications. Recent studies reinforce the role of CT as the imaging method of
reference, superior to other techniques.
