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Acute pancreatitis
This is a CECT Abdomen & Pelvis report from 14/04/2026 for Subhajit Chanda, 43M, from Aditya Birla Memorial Hospital.
Please suggest what should we do
Answers (12)
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"Acute Pancreatitis is a serious inflammatory condition of the pancreas that requires immediate and intensive medical management. Based on the CECT Abdomen & Pelvis report, it is crucial to assess the 'Balthazar Score' or the degree of pancreatic necrosis (tissue death) and fluid collection. This condition can lead to systemic complications if not monitored closely. The management strategy focuses on resting the pancreas, aggressive hydration, and pain control."
Next Steps
"1. Pancreatic Rest: The patient usually needs to be 'NPO' (Nothing by Mouth) to prevent the pancreas from secreting digestive enzymes that further damage the organ.
2. Aggressive IV Fluids: Pancreatitis causes significant fluid shifts in the body, which can lead to kidney issues if not managed with IV fluids.
3. Complication Monitoring: CECT reports help identify if there are any pseudocysts, abscesses, or vascular complications that might require surgical or radiological intervention."
Health Tips
"1. Immediate Admission: If the patient is not already hospitalized, they must be admitted to a multi-specialty center with a Gastroenterology department.
2. Serial Monitoring: Regular blood tests including Serum Amylase, Lipase, CBC, and LFT are needed to track the progress of inflammation.
3. Pain Management: Severe abdominal pain (typically radiating to the back) requires injectable analgesics under medical supervision.
4. Follow-up Imaging: A repeat scan might be needed depending on the clinical recovery to rule out walled-off necrosis."
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Thank you for posting your query
CECT shows Necrotising Pancreatitis - It’s critical condition since you have not mentioned his symptoms but I assume about Severe pain/ Nausea / fever may be
He need IMMEDIATE HOSPITALISATION, Agressive Management, with Fluid and high Antibiotic plus analgesics
Next Steps
Admit him under a Gastroenterologist if not done so far and follow his advise
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Serious condition. Consult gastroenterologist medical or surgical.
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Acute necrotizing pancreatitis is a serious condition and requires close medical supervision, often in a hospital setting.
Since the report already shows pancreatic inflammation with necrosis, it is important that he continues under the care of a physician or a gastroenterologist and does not manage this at home.
Treatment includes Strict monitoring,IV fluids, pain control, Nutritional support,Watching for complications
Mild hepatomegaly can be reactive and will be evaluated along with this.
Please ensure he is under active medical care.
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Acute necrotizing pancreatitis. Inflamed pancreas with necrosis and mild hepatomeghaly due to underlying causes.iv fluid and antibiotic treatment is main stay of your treatment. Avoid alcohol completely because its worsens the disease. You need general physician and gastroenterologist combined approach to treat this well.eat soft and easily digestable diet .you need to start treatment as much as possible because its not reversible without treatment.
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The CECT findings are suggestive of acute necrotizing pancreatitis with a high severity index (8/10), which indicates a moderately severe to severe form of pancreatitis. There is evidence of pancreatic and peripancreatic necrosis (<30%) along with significant fluid collections extending into the pelvis, which needs close monitoring.
Associated findings like mild hepatomegaly, minimal pleural effusion, and reactive changes in surrounding structures are commonly seen in such cases. Importantly, there is no splenic vein thrombosis at present, which is reassuring.
Overall, this is NOT A MILD CONDITION and requires structured medical management under supervision, as complications (infection, organ dysfunction) can develop during the course.
Next Steps
Patient should ideally be managed/admitted under a gastroenterologist or physician in a hospital setting.
Strict monitoring of vitals, urine output, and laboratory parameters (CBC, CRP, LFT, RFT, serum amylase/lipase).
Aggressive IV fluid management is crucial in the early phase.
Pain management and supportive care
Nutritional support (preferably early enteral feeding if tolerated).
Watch for signs of infected necrosis (fever, worsening pain, rising counts), which may require antibiotics or intervention.
Repeat imaging may be needed if clinical condition worsens or does not improve.
Evaluate and address the underlying cause (alcohol, gallstones, triglycerides, etc.) to prevent recurrence.
Health Tips
-Avoid alcohol and fatty meals completely
-DO NOT RELY ON HOME TREATMENT or delay hospitalization in moderate–severe pancreatitis
-Seek urgent care if there is increasing abdominal pain, persistent vomiting, fever, breathlessness, or decreased urine output
-Recovery can take time; close follow-up is essential to monitor for late complications like pseudocyst formation
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Medical gastro or surgical gastro opinion
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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