Ultrasound images of Focal pancreatitis

the gland. Occasionally, areas of hypoechoic, focal acute or chronic pancreatitis are present (see Pancreatitis, above). These are invariably a diagnostic dilemma, as they are indistinguishable on ultrasound from focal malignant lesions (Fig. A & B ). Factors which point towards inflammation include  a previous history of pancreatitis and a normal CA 19–9 tumour marker level. Because malignant lesions are frequently surrounded by an inflammatory reaction, biopsy is also of questionable help in differentiation of focal benign and malignant lesions.
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(A) Ultrasound images Focal acute pancreatitis in the head of the pancreas. The CBD is obstructed by a hypoechoic mass in
the head, with blood clots and debris within the duct. The differential diagnosis was malignancy.
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(B)The same patient 8 months later. The Ultrasound images acute inflammation has resolved, the obstruction is relieved and the pancreas now appears
hyperechoic with a mildly dilated duct, consistent with chronic pancreatitis.
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