Pancreatitis

The initial complaint was divided into five categories: abdominal pain, abdominal discomfort, abdominal trauma, fall trauma, and MVC. Abdominal pain in these categories refers to severe abdominal pain lasting from hours to a few days where the initial approach from the ED physician was to asses for life threatening causes. Abdominal discomfort refers to less serious causes of abdominal pain such as constipation, gastritis, and diverticulosis. Abdominal trauma refers to blunt trauma, impact with an object, or penetrating injuries. Fall traumas refer to blunt traumas from deceleration from different type of falls, and MVC from deceleration from a vehicle impact and collision. We removed two cases that did not fit within these categories. Initial imaging results were categorized as negative or positive. The acute positive result included radiology reports describing infection (appendicitis, colitis, diverticulitis, and pyelonephritis); inflammation (pancreatitis and inflammatory bowel disease), masses and malignancies; and vascular abnormalities (gastrointestinal bleeding, aortic dissection, and abdominal aortic aneurysm). Positive incidental findings were categorized into hernia, cyst, nodule/mass, liver disease, renal calculi/malfunction, gastrointestinal, thoracic/chest cavity, and genitourinary issues.
We noted whether the patient had received any follow-up imaging of the same body region (up to 90 days from initial presentation and imaging). Imaging follow-up type was categorized as CT and magnetic resonance (MR) of the abdomen and pelvis with and without contrast, abdominal ultrasound, abdominal CT angiography (CTA), and abdominal X-ray. Follow-up report status either confirmed findings (negative, acute, and incidental) or identified a missed finding/false adverse finding. A board-certified, abdominal fellowship-trained radiologist re-evaluated reports and associated imaging in order to confirm any missed/false-negative results.