Ultrasound images Chronic pancreatitis

The pancreas becomes abnormally hyperechoic (Fig. A). This should not be confused with the normal increase in echogenicity with age. The gland may be atrophied and lobulated and the main pancreatic duct is frequently dilated and ectatic, with a beaded appearance.
Calcification may be identified in the pancreatic tissue, both on ultrasound and on a plain X-ray, and there may be stones in the duct. (Generally
speaking, strong shadows are cast from the calcific foci, but small flecks may be too small to shadow) (Fig 5.4 B, C).
As with acute inflammation, CT is the method of choice for demonstrating the complications of chronic pancreatitis. Obstruction of the duct can cause pseudocyst formation, and other complications include biliary obstruction and portal/splenic vein thrombosis.
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Fig. A Chronic pancreatitis in a patient with alcoholic cirrhosis  the pancreas is hyperechoic compared with
the liver and has a heterogeneous texture with a lobulated outline.
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Fig. B Calcification of the pancreas in hereditary
pancreatitis.
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Fig. C
A cycle of acute on chronic pancreatitis, with pseudocysts and considerable calcification.
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