Inflammation of the pancreas may be acute or chronic and is usually a response to the destruction of pancreatic tissue by its own digestive enzymes (autodigestion), which have been released from damaged pancreatic cells.
Ultrasound images Acute pancreatitis.
Clinical features Acute inflammation of the pancreas has a number of possible causes (Table A ), but is most commonly associated with gallstones or alcoholism. Clinically it presents with severe epigastric pain, abdominal distension and nausea or vomiting. In milder cases, the patient may recover spontaneously. If allowed to progress untreated, peritonitis and other complications may occur. Biochemically, raised levels of amylase and lipase (the pancreatic enzymes responsible for the digestion of starch and lipids) are present in the blood and urine. Acute inflammation causes the pancreatic tissue to become necrosed, releasing the pancreatic enzymes which can further destroy the pancreatic tissue and also the capillary walls, entering the blood stream.
Ultrasound images pancreatitis
Mild acute pancreatitis may have no demonstrable features on ultrasound, especially if the scan is performed after the acute episode has settled. In more severe cases the pancreas is enlarged and hypoechoic due to oedema. The main duct may be dilated or prominent. As the condition progresses, digestive enzymes leak out, forming collections or pseudocysts. These are most frequently found in the lesser sac, near the tail of the pancreas, but can occur anywhere in the abdomen—within the pancreatic tissue itself, anywhere in the peritoneal or retroperitoneal space or even tracking up the fissures into the liver—so a full abdominal ultrasound survey is essential on each attendance (Fig. below). Pseudocysts are so called because they do not have a capsule of epithelium like most cysts, but are merely collections of fluid surrounded by adjacent tissues. A pseudocyst may appear to have a capsule on ultrasound if it lies within a fold of peritoneum. Pseudocysts may be echo-free, but generally contain echoes from tissue debris and may be loculated. In a small percentage of cases, a pseudocyst or necrotic area of pancreatic tissue may become infected, forming a pancreatic abscess. Although acute pancreatitis usually affects the entire organ, it may occur focally. This presents a  diagnostic dilemma for ultrasound, as the appearances are indistinguishable from tumour. The clinical history may help to differentiate; suspicion of focal pancreatitis should be raised in patients with previous history of chronic pancreatitis, a history of alcoholism and normal CA 19–9 levels (a tumour marker for pancreatic carcinoma). The enlargement of the pancreas in acute pancreatitis may have other consequences, for example the enlarged pancreatic head may obstruct the common bile duct, causing biliary dilatation. Doppler ultrasound is useful in assessing associated vascular complications. Prolonged and repeated attacks of acute pancreatitis may cause the splenic vein to become encased and compressed, causing splenic and/or portal vein thrombosis, with all its attendant sequelae (Fig.below). Although ultrasound is used to assess the pancreas in cases of suspected acute pancreatitis, its main role is in demonstrating the cause of the pancreatitis, for example biliary calculi, in order to plan further management. The ultrasound finding of microlithiasis or sludge in the gallbladder is highly significant in cases of suspected pancreatitis, and has been implicated in the cause of recurrent pancreatitis.
Ultrasound images Acute pancreatitis in a patient with alcoholic liver disease. The pancreas is hypoechoic and bulky with a lobulated outline.
Ultrasound images Large pseudocyst near the tail of the pancreas in acute pancreatitis
Ultrasound images Necrotic tail of pancreas surrounded by exudate.
Ultrasound images Inflammatory exudate is seen around the right kidney in acute pancreatitis Table A Causes of acute pancreatitis Biliary calculi—most common cause. Obstructs the main pancreatic duct/papilla of Vater and may cause reflux of bile into the pancreatic duct. Alcoholism—alcohol overstimulates pancreatic secretions causing overproduction of enzymes Trauma/iatrogenic—damage/disruption of the pancreatic tissue, e.g. in a road traffic accident, or by surgery, biopsy or ESWL Drug-induced—a relatively uncommon cause. Some anticancer drugs can cause chemical injury . Infection—e.g. mumps. A rare cause of pancreatitis Congenital anomaly—duodenal diverticulum, duodenal duplication, sphincter of Oddi stenosis or choledochal cyst may obstruct the pancreatic duct, giving rise to pancreatitis Hereditary—a rare, autosomal dominant condition presenting with recurrent attacks in childhood or early adulthood. ESWL = extracorporeal shock wave lithotripsy.

Artikel Terkait

4/ 5


Suka dengan artikel di atas? Silakan berlangganan gratis via email

This below all content of radiology information

Neuroradiology Musculoskeletal radiology MRI Musculoskeletal MRI Abnormal Mri Brain X-RAY differential diagnosis Head Neck Anatomy mnemonic CT Teleradiology Radiology News chest Radiology musculoskeletal salary pediatrics ultrasound ultrasound images job Brain tumour abdomen interventional radiology CT Abdomen with contrast DAMS Imaging Apk Android radiology ramblings residency c nature pediatric radiology random ramblings xray C T Radiology Top basics body imaging guide procedure web 2.0 Chest X Ray Interpretation Teleradiology Providers head and neck radiology video Fun b cancer chest radiology salary 1 CXR GenitoUrinary ORTHOPEDICS Sonographic Measurements Stroke Ultrasound Hepatitis dams md/ms coaching mammography radiology business tuberculosis BRAIN Clinicoradiological series FETUS GI radiology Gastrointestinal x ray Radiology 4 Radiology Conferences Radiology Images Telemedicine UPPER LIMPS Ultrasound in Emergencies dynamic MRI lifestyle radiology links renal case spine 3 tesla MRI Dams clinicoradiological series Entrepreneur Gastrointestinal Tract Images Literature Liver abscess ultrasound MD/MS coaching Radiology 40 Radiology Imaging Radiology Journal Radiology PDF Radiology mcqs Ultrasound Technique blog bone tumour cardiac CT career cerebral venous thrombosis chest xray d fracture gadolinium gastrointestinal genitourinary radiology hepatobiliary imaging lipoma medical blogs mri lower abdomen pelvis psychiatry radiation concern social networking technology training urogenital imaging weblog 3D CT Arachnoid cyst CT Cardiac Chest X Ray Diploma Guid Equipment Cost FDA Fibrous dysplasia Interventional Ultrasound Guiding Biopsi MDCT MR Pancreas MRI Vertebrae MRI Vertebrae lumbal MRI contrast MRS RTA Radiology Teaching resource TB Hip TECHNIQUE Tech Thorax X Ray Upper Ext aiims ankle sprain bowel cancer brain abscess case study computers and radiology contrast ependymoma epidermoid facebook guest post internet journal of radiology iphone kienbock disease liver liver segments ct locum tenens mri abdomen multislice CT pericallosal lipoma plain film teaching files private practice radiology humour shoulder arthrogram shoulder dislocation small bowel social media trigeminal neuralgia tuberous sclerosis venous x ray Vertebrae 3d printing 7 tesla MRI ACL reconstruction ACL tear ACLS AIIMS nov 2008 ALPSA lesion ANGIOGRAPHY ATFL B12 deficiency BLS BOLD Breast imaging Breast imaging Mammography CHF CT Paranasal CT Scanner Price CT angiography CT coronary angiography CT technology CV junction CXR teaching files Carcinoid Contrast Agent Creutzfeldt-Jakob Disease Dams MD/ms Dams grand rounds Diffusion weighted imaging Dysmenorrhea E E World Award 2011 EYE Embolization Imaging Entrepreneurship FMG India FMGE FNH Focal liver lesions ultrasound Focal nodular hyperplasia GBM GI Gall bladder Glioblastoma multiforme Glomus jugulare HEAD HEART HRCT HSG Head injury ICA dissection IRIA 2011 IUGR IVC filter Iliotibial Band Friction Syndrome Job Info Kidney Cancer LV thrombus Leptomeningeal cyst MAMOGRAPHY MCI Screening MD MPPG MR mammography MR urography MRA MRCP MRI Cervical MRI update MRI/PET MRV Mesenteric ischemia Middle East respiratory syndrome coronavirus (MERS-CoV) Motor neuron disease NECK Normal Liver US Oncology trial PDF Radiology PM and R Physician PNS Partial anomalous pulmonary venous drainage Persistent trigeminal artery Pg entrance Physiatrist Physiatry Physician Assistant Plastic Surgery Price MRI Machines 2017 Pulmonology Pulvinar sign Radiology Price List Radiology Today Radiology Updates Radiology grandrounds Radiology images of GI Tract Renal Ultrasound Retinal Surgery Rheumatology Ryles tube SKULL Seizure Sellar Masses Sleep Medicine Sports Medicine Subdural hematoma Surgery TBM TRIANGULAR FIBROCARTILAGE COMPLEX Trauma Surgery URI Ultrasound HIV Umbilical vein Update Article Upper Extremity X Ray Urology Usmle VHL Vascular Surgery Veteran Affairs X Ray Head about accessory bone acute cerebillitis acute pancreatitis aiims may 2011 aipg ankle ankle fracture apple articular cartilage aspergilloma atherosclerosis avulsion injury awards bankart lesion basilar artery thrombosis bilateral phaeochromocytoma biopsy bipolar bohler's angle bone tumours brachial plexus brain tb brainstem stroke branchial cyst breast cancer screening buford complex business today calcaneal fracture calcium scoring canned reports carcinoma esophagus carcinoma stomach cardiac ct/pet cardiac pacemaker cardiogen 82 cardiothoracic imaging catrotid artery dissection cavernoma cervical lymphnode levels chest radiographic score chest radiographs choledocolithiasis classification cloud computing cochlear implant colloid cyst communication in radiology compare case concha bullosa congenital brain anomalies congenital heart disease coronary CT coronary artery disease corpus callosum agenesis craniopharyngioma cryptococcal meningitis ct abdomen and pelvis cystic renal disease dams usmle dams visual treat deep brain stimulator dengue dengue hemorrhagic fever developmental dysplasia devices diagnostic imaging dialysis diffusion MR imaging diffusion tensor imaging diffusion tractography digital radiography distal facial neuroma dsa duplication gall bladder echinococcus echocardiography ectopic kidney elearning elevated diaphragm epilepsy esop facial neuroma fibular osteosarcoma functional mri gastrointenstinal tuberculosis germinoma gifts glioma google google plus gun shot injury haemangioblastoma health 2.0 healthcare consultancy hemangiblastoma hemophilia hippocampus hirayama disease hydatid cyst hypercoagulable hypoxic ischemic encephalopathy indian conferences inferior rectus anomaly infrared interior tomography interstitial lung disease intramedullary metastates intramedullary tuberculomas ipad ipad 2 jacoud's arthropathy kernohan's notch knee kohler's disease krukenberg tumour laceration leber's optic atrophy liver transplant lung contusion lymphatics macros marchifava bingami disease mastoiditis maxillary sinus mucocele medial malleolus ossicle medial tibial stress syndrome medical writting medicare medicolegal aspects of teleradiology migraine mortality motor area mri knee mri lumbal msk penang course mucinous cystadenoma multicentric Glioblastoma multiforme mycotic pseudoaneurysm of superficial temporal artery nephrogenic systemic fibrosis nephrology neurosurgery meets nonradiologist oesophagus olecranon spur online medical games open access opercular syndrome opinion orbit os odontoideum os radiale externum osirix osteochondritis osteochondroma osteoid osteoma outsourcing radiology ovarian tumour parameniscal cyst paranasal sinuses parotid vascular mass patellar sleeve avulsion fracture patent ductus arteriosus patent foramen ovale patient information pelvic MRI pericardial fat phaeochromocytoma pharmaceutical writting pineal tumour placenta accreta placenta increta placental insufficiency pneumococcal pneumonia polycystic kidney disease portal Hypertension posterior circulation stroke power point presentation primary complex protected health information pseudobulbar palsy pseudomyxoma peritonei publications pulmonary edema pulmonary embolism pulmonary tuberculosis rabbit ear sign rad radiographic deterioration pattern radiography radiolo radiologist blogs radiology city radiology debate radiology images of spleen radiology intervensional radiology learning radiology search engine radiology spotter radiology spotters radiolopolis raditudes rathke cleft cyst renal imaging renal sinus tumour right sided aortic arch robot round cell tumour sacral agenesis scaphoid fracture schatzki ring scientific content screening search engine secondaries secondary ossification centres silicosis social radiology soft tissue chondroma solitary pulmonary nodule spectroscopy spinal arachnoid cyst spinal cord tumours spinal osteochondroma spine tumour spinoglenoid cyst sternal tuberculosis stress fracture sacrum stroke mri sub-acute combined degeneration subclavian pseudoaneurysm subependymal giant cell astrocytoma sumer sethi swyer-james syndrome syringomyelia tb teaching video teleradiolo teleradiology business models teleradproviders teleultrasound temporal bone fracture tendoachilles testicular tumour tethered cord. MRI tibial stress fracture total knee arthroplasty total shoulder replacment trachea. tracheal diverticulum tracheal stenosis tracheomalacia traumatic lung cyst triceps tear triquetral fracture tubercular abscess tuberculoma tuberculosis elbow ultrasound image of The segments of the liver umblical artery doppler uroradiology vascular malformation vasovist venous angioma ventriculitis video ct scan video mri viral encephalitis vitamin deficiency