RESUMO
Purpose: Acute pancreatitis (AP) is common among children in Bangladesh. Its management depends mainly on risk stratification. This study aimed to assess the severity of pediatric AP using computed tomography (CT). Methods: This cross-sectional, descriptive study was conducted in pediatric patients with AP at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh. Results: Altogether, 25 patients with AP were included, of whom 18 (mean age, 10.27±4.0 years) were diagnosed with mild AP, and 7 (mean age, 10.54±4.0 years) with severe AP. Abdominal pain was present in all the patients, and vomiting was present in 88% of the patients. Etiology was not determined. No significant differences in serum lipase, serum amylase, BUN, and CRP levels were observed between the mild and severe AP groups. Total and platelet counts as well as hemoglobin, hematocrit, serum creatinine, random blood sugar, and serum alanine aminotransferase levels (p>0.05) were significantly higher in the mild AP group than in the severe AP group (p=0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of CT severity index (CTSI) were 71.4%, 72.2%, 50%, and 86.7%, respectively. In addition, significant differences in pancreatic appearance and necrosis were observed between the two groups on CT. Conclusion: CT can be used to assess the severity of AP. In the present study, the CTSI effectively assessed the severity of AP in pediatric patients.
RESUMO
A total of forty two clinically diagnosed pediatric brain tumors were studied over a period of two years. The study was aimed to evaluate the efficacy of computed tomography (CT) in pre-operative diagnosis of pediatric brain tumors by correlating the imaging findings with postoperative histopathological findings. Site, density, mass effect and contrast enhancement of the lesion were studied as primary efficacy variables of CT scan. In the present study, the common pediatric brain tumors were astrocytoma, medulloblastoma, craniopharyngioma and ependymoma. In 18(42.9%) cases the tumors were supratentorial and in 24 (57.1%), they were infratentorial in location. The findings of CT scan in different intracranial neoplasm strongly correlated with those of histopathology. The validity tests for CT scan were found to be 88.9% sensitive, 100% specific and about 95% accurate in diagnosing astrocytoma. Similarly the sensitivity, specificity, and accuracy for medulloblastoma were 100%, 96.9% and 97.7% respectively. For craniopharyngioma the values were 85.7%, 100% and 97.7% respectively. The study concludes that CT is an invaluable imaging modality in preoperative diagnosis of pediatric brain tumor due to its excellent characterization of tumors.
