 Good afternoon, everyone. I'm Dr. Nikhad Bano, third year radiology resident from MGM Medical College and Hospital Orangabad. The topic of my paper presentation is computer tomography evaluation of complications of pancreatitis. Now, as we all know, acute pancreatitis, it is a disease with high morbidity and mortality with an unpredictable cause. It has broad spectrum that varies from mild to severe forms with significant focal and systemic complications. Severe pancreatitis is characterized by a protracted clinical course, multi-organ failure and pancreatic necrosis. The majority of patients with mild disease recover completely. However, 15 to 20% of patients develop clinically severe acute pancreatitis with local and systemic complications. Now, the CT is the most standard for evaluation of pancreatitis because it is a non-invasive method of evaluating the morphology of pancreas and peripangreatic regions as it is not affected by gas, distribution and obesity. CT severity is most important during the initial work of acute pancreatitis and therefore various CT scoring systems are available. CT severity index developed by Balthazar and Motel are used and a total score of 10 points is done. Computer tomography scan with IV contrasting is required to determine the presence and extent of pancreatic necrosis as well as inflammatory changes, local and extra pancreatic complications. The aim of the study is to determine the role of computer tomography in early diagnosis of acute pancreatitis and to evaluate the complications using modified CT severity index versus the severity of acute pancreatitis. Now, the materials and methods are, this is a prospective observation of study and it was carried out in 60 patients over a period of two years. All the patients who were suspected of having acute pancreatitis on clinical findings as well as ultrasonography and the patient who presented as acute on chronic pancreatitis were included in the study. The exclusion criteria were deranged in a function test patients with sensitivity to iodinated contrast media and suspected acute pancreatitis patients with normal pancreas on CT scan. Examinations were performed on 128 slice CT scanner and a contestant on CT scans were obtained after IV injection or PtML of non-anid contrast medium. Triple phase scans were obtained and standardly for arterial phase of 20 seconds was used, venous phase of 60 seconds and pancreatic pancreatic pancreatic phase of 35 seconds was used. The modified CT severity indexes as follows, a zero point are given for normal pancreas, two points are given for inflammation of the pancreas or the peripancreatic fat stranding and four points are given for pancreatic or peripancreatic fluid collections. Now, for less than 30% of pancreatic necrosis, two points are given and for more than 30% of pancreatic necrosis, four points are given. Tural effusion, extra pancreatic complications are given four points. Now our score of 0 to 2 is it is graded as mild pancreatitis, 4 to 6 is graded as moderate pancreatitis and severe pancreatitis is graded by total score of 8 to 10. Now these are the results of our study when the 25% of patients showed normal size of the gland and 41% showed diffuse enlargement of the gland. The 36% patient page of patients showed focal enlargement of the gland. Admetus pancreatitis was obtained in 25% of patients, less than 30% necrosis was obtained in 16 patients and four patients showed more than 30% of pancreatic necrosis. Peripancreatic fat stranding was the common spining and it occurred in 90% of patients. Peripancreatic fluid collection was obtained in 78% of patients. Now the focal enlargement was observed in 22 patients out of which head and neck was the most common area involved. Commonest side of fluid collection was the LSSAC and fluid collection as well as pseudosis formation was the LSSAC. The extra pancreatic complications site is pleural effusions, pleinic vein thrombosis, portal vein thrombosis and pancreatic or pleural fistula. Only one patient showed the fistula formation. We observed mylipancreatitis in 29 patients, moderate in 18 and severe in 13 patients. Patient with severe pancreatitis required intensive care management. Now in figure one, we can appreciate that there is diffuse non-enhancing area involving the pancreas as well as peripancreatic fat stranding and fat stranding in the right parapolycuta. This suggests a pancreatic necrosis. Now in the figure two, we can appreciate that there is a fluid collection, well defined fluid collection with thin margins in the LSSAC region. In a patient of pancreatitis, this was a pseudosis formation in the LSSAC. Now, we can also appreciate there is a hypodense area in the spleen, wedge shape, digestive of spleenic infarct because of spleenic vein thrombosis. Now, because of proteolytic effects of the pancreatic enzyme on the various vascular structures, there are this results in erosion and formation of pseudonism. The thrombosis arising from the branch of the right hepatic artery. Now, we can also appreciate a pseudonism formation of the spleenic artery. Now acute pancreatitis, it is defined as acute inflammatory process of the pancreas that may involve peripancreatic tissues and remote organ systems. Acute pancreatitis divided into acute edematous and acute necrotizing pancreatitis. Acute edematous pancreatitis consists of diffuse or localized enlargement of the pancreas due to inflammatory edema. And necrotizing pancreatitis occurs due to necrosis of pancreatic, peri-pancreatic tissue or both. Contrasting and citrus, patching on and enhancing areas because of necrosis of the pancreas. Local complications can be peri-pancreatic and lecrosis, it could be steroid infected, peri-pancreatic fluid collection, pseudosis formation, involvement of pancreas, organs, vascular complications or obstructive jaundice. The main purpose of CT stresses the CBRR of the disease. Now, only, we observed that there was no association between the age and gender with severity of pancreatitis. However, percentage of necrosis severity of pancreas higher with alcoholic pancreatitis. Pancreatic necrosis seen as focal lawn in the lower Danishian area and therefore 16 had less than 30% of necrosis and 4 had more than 30% of necrosis. In this, we can appreciate that the most common set of extra pancreatic phlegmon like pseudosis formation was the lecissac region followed by left anterior paralenal space. We observed 29 patients with pancreatitis and 13 with severe pancreatitis showed the lecissac formation. The extra pancreatic complications are the major cause of morbidity and mortality in pancreatitis. The spleenic vein thrombosis of the pancreatic tributaries of the portal vein as well as the spleenic vein was occluded in 45% of patients with pancreatitis. Vascular complications can lead to light threatening hemorrhage due to arterial erosion and venous thrombosis and therefore spleenic artery, pancreatic odena and gastrodena are most commonly involved in acute pancreatitis. CT health and diagnosis of pancreatitis as well as identify the fluid collection patient with hemorrhage determine the extent of inflammatory process and its proximity to important muscular structures. Now we noted pseudonylism formation of thrombosis of the right hepatic artery as discipline figure three. Pseudosis which were encapsulated collection of pancreatic fluid was seen in 29 patients and in 14% it was located in the lecissac. The CT scores were classified into 2, 4, 6, 8 and 10. The maximum patients were seen with score of 2 and 4 and minimum with score of 8 and 10. Modified pancreatitis was observed in 30% of patients. So to conclude, Contracenal CT scan of abdomen in acute pancreatitis has been differentiating between acute edematous and necrotizing. It has to predict the possibility of developing local and systemic complications. Ultrasound of abdomen followed by CT helps in early and better anatomical delineation of complications of acute pancreatitis. It has been better treatment planning more effectively, accurately and early. Modified pancreatitis can be managed conservatively whereas high score requires intensive care management. Thank you. These are the references. Thank you.