 I am Dr. Fnizh Abdelassi, Junior Resident of K-Cigarette Medical Academy, Mangaluru. I am presenting a paper on the topic of role of MDCT in evaluation of various pancreatic abnormalities. Aimed to assess the role of MDCT in evaluation and detection of inflammatory neuroplastic trauma of pancreas and developmental anomalies of pancreas. Introduction Pancreatic abnormalities varies from inflammation to malignancy and are associated with high morbidity and mortality. Hence, pancreatic imaging is essential tool in early diagnosis and staging of pancreatic disease. Modality for imaging pancreas include abdominal radiograph, ultrasound, CT, MRI, endoscopic ultrasound, ERCP, PET CT. Computer tomography is the backbone of pancreatic imaging. Intravenous contrast is nearly always indicated with multi-phase enhanced imaging being the optimal for identifying and characterizing pancreatic masses or complication from pancreatitis. Multi-phase pancreas protocol will usually include an unenhanced sequence, a pancreas phase or late arterial phase as well as potovenous phase sequence. MDCT is highly sensitive in dictating necrosis, pancreatitis, peripangreatic fluid collections, calcification, neuroplasm, pancreatic enlargement, atrophy and cystic lesion of pancreas. Materials and Methods Place of study Department of Radiology of Justice K-Cigarette Charitable Hospital in Mangaluru Type of study Cross-sectional Observational Study Period of study August 2022 to August 2023 Sample size 88 cases Inclusion criteria Patient with complaints Adjustive of pancreatic disease Based on clinical presentation Laboratory or Ultra Sonography findings CECT examinations were conducted with GE128 Slice CT scanner Observations and results Out of 88 cases Inflammatory causes include 64% that means 56 cases That acute pancreatitis cases include 42.8% Acute and chronic pancreatitis cases include 21.4% and chronic pancreatitis cases include 35.7% 28% of cases of total comes under neoplasm and 1% Trauma to pancreas and 7% Developmental Anomaly of pancreas. Inflammatory Pathology First Acute pancreatitis This bar chart has shown age-wise distribution of cases Among 1 to 20 years age group 16.6% of cases are noted Among 20 to 39 years of age group 37.5% of cases are noted Among 40 to 59 age group 41.6% of cases are noted More than 60 years of age group 4.1% of cases are noted This pie chart shows the male and female distribution of cases where 83% of cases are male Type of Acute Pancreatitis There are two types Acute Industrial Pancreatitis and Acute Necrotizing Pancreatitis 71% of cases comes under Acute Industrial Pancreatitis CT findings Normal glands are noted in three cases Diffuse enlargement In 12 cases, focal enlargement is seen in 9 cases Peripangreatic fast stranding is noted in 22 cases Peripangreatic fluid collection is noted in 15 cases Most commonly seen extra-pangreatic complications include pleural effusion in 12 cases and a site is in 15 cases out of 24 cases This table shows modified CT severity score grading in Acute Pancreatitis Majority of Acute Industrial Pancreatitis cases have fallen under moderate grade while majority of Acute Necrotizing Pancreatitis cases have fallen under severe grading This table shows the distribution of pseudocyst and Waldorf necrosis in Acute Industrial Pancreatitis, Acute Necrotizing Pancreatitis, Acute Necronic Pancreatitis and Chronic Pancreatitis Pseudosis is seen more commonly in Acute Necronic Pancreatitis but it is also seen in Chronic Pancreatitis, Acute Necrotizing Pancreatitis and Acute Industrial Pancreatitis While Waldorf necrosis is seen only in Acute Necrotizing Pancreatitis in our study Chronic Pancreatitis Age-wise distribution of cases is shown in this bar diagram Out of total 20 patients, cases having age group less than 20 There is no cases And among the age group of 20 to 39, 45% of cases are noted Among the age group of 40 to 59, 50% of cases are noted Among the age group more than 65% of cases are noted And this pie chart shows the age distribution male and female distribution of cases In that 85% of cases of Chronic Pancreatitis are male CT findings are shown in this table 20.4% of cases shows atrophy of pancreas 34% of cases shows parangymal calcification while 13.6% of cases shows intradactile calcification MPD dilatation noted in 8 cases Surosis noted in 11.3% of cases while pancreatic or pleural fistula as a complication noted in 2.2% of cases Pancreatic Neoplasm A total of 25 cases of neoplasm out of which 72% of patients demonstrated solid neoplasm pancreatic lesion And 28% of patients had cystic pancreatic neoplasm Solid neoplasm include adenocarcinoma 44% and pancreas neuroendocrine tumor 12% and metastasis include 16% Cystic neoplasm include Sirus cyst adenoma 4% and MCA 8% of cases SPN 4% of cases and IPMN 12% of cases Among solid neoplasm of pancreas adenocarcinoma is seen more common 44% out of 12 patients of adenocarcinoma pancreas 6 cases 54.4% is above 50 age group with male predilection 81.8% 72.7% of cases shows involvement of head and insinine process in adenocarcinoma of pancreas Developmental anomaly of pancreas Out of 6 cases of developmental anomaly of pancreas 66% age found in female cases of annular pancreas are found as an incidental finding while imaging in adult patients No cases Acute industrial pancreatectis Head and body measures Here head and body measures 4.2 and 2.4 centimeter It appears enlarged in size Pancreatic debt is not dilated No parenchyma or ductile calcification is seen and there is a significant peripangreatic fast standing such as steve of acute industrial pancreatitis Next case In this body and tail are enlarged in size and parenchyma is replaced by periphery enhancing thin walled fluid density There are few enhancing island of parenchyma within the fluid density The head and neck of the pancreas is normal in size and shows mild degrees in attenuation and enhancement pattern with peripangreatic fat standing and this image shows bilateral purula fusion left side more than right side And this is the case of necrotizing pancreatitis with the walled of collection Next case Head and neck of pancreas are mildly enlarged Hypo attenuating and show hyper enhancement Body and tail are atrophic Few specks of calcification noted within the head and insinate process Small peripherally enhancing collections are noted posted to the head and insinate process Similar collection noted in the lesser sac anterior to the pancreatic tail abetting the posterior wall of the body of stomach Chronic calcific pancreatitis Pancreas is atrophic With the parenchyma thinning Main pancreatic duct is dilated Measure 6.4 mm in the body region Multiple dectyl or parenchyma calcifications noted in the head Insinate process and tail Largest measuring 9.4 mm within the MPD in the head region Now, case of pancreatic laceration A well defined hypodence known enhancing the Agen measuring 23 into 18 mm noted in the region of neck of the pancreas It is noted involving the pancreatic parenchyma and communicating with the MPD Rest of the parenchyma appears bulky with normal attenuation and enhancement pattern So instead of pancreatic laceration Now discussion A total of 88 patients of our OPD and the IPD were included in the present study to assess the role of computer tomography in evaluation of pancreatic abnormalities and various abnormalities were detected The study observed the commonest pancreatic pathology was of inflammatory etiology followed by pancreatic carcinoma Inflammatory etiology, acute pancreatitis cases were common and among neoplasm, adenocarcinoma cases are encountered more More common CT features of acute pancreatitis include bulky pancreas and fat stranding followed by peri-pagnetic fluid collection Extra-pagnetic manifestation include acitis being more frequent followed by pleural effusion and some cases show thrombosis of vessel World of necrosis is seen only in case of necrotizing pancreatitis with high significance stating its specificity Most common CT features of chronic pancreatitis include parangymal calcification followed by atrophy Other features include ductile calcification and MPD dilatation Pancreatic neoplasm shows male predilection Adenocarcinoma of pancreas shows involvement of head and unsinate process in majority of cases Few cases of anomalies of pancreas and trauma to pancreas are also detected Now conclusion MDCT is excellent diagnostic modality in assess the severity of inflammatory process, traumatic injury and neoplastic lesion MDCT imaging with its post-processing technique is the imaging modality of choice for diagnosing pancreatic masses It is standard investigation to identify and quantify distribution of various pancreatic lesion and also evaluate the activity and progression of disease It helps in equity diagnosis and characterization of lesion in proper treatment of patients