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.

(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.

(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.