Google+ 54.204.200.90
Open-Close Option Buttons MedPix® 12163 Cases :: 57493 Medical Images :: 42695 Registered Members
| | | | | | | | :: compass
Look for :: ::

Working ...

MedPix® Home Page Search Patient Charts: Pancreatitis URL for This Search

  Results for [ Pancreatitis ]   - Click for Details and More Options
Search Results for => Pancreatitis <= Result Items 1 - 20
Using tf_case_results.php3 function


Case ID: 13118

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisNecrotizing Pancreatitis
HistoryOne week progressive epigastric pain; negative cardiac workup.
FindingsAxial contrast enhanced CT images of the abdomen demonstrates nonenhancement of the majority of the pancreas with extensive peripancreatic fat stranding and retroperitoneal fluid. Associated small bowel dilation consistent with ileus and pleural effusions.
Differential DxNecrotizing Pancreatitis- specific clinical presentation and imaging Pancreatic or ampullary mass with massive duct dilation
Discussion ... (continues ...)
User Group
ContributorDavid Heltzel :: National Capital Consortium - Author Info
ReviewerRachel Booth Lewis :: National Naval Medical Center Bethesda - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 12434

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisGallstone Pancreatitis
History74 yo male who presented to the ER with a three day history of progressive epigastric and right upper quadrant pain.
FindingsOn Ultrasound imaging the patient had mild gallbladder wall thickening to 4 mm and common bile duct dilation to 9 mm. Neither an obstructing lesion nor the pancreas was visualized on ultrasound. On CT scan of the pancrease, there was mild gall bladder wall thickening, CBD dilatation, inflammatory fat stranding around the pancreas and duodenal small bowel and a circular hyperdensity in the distal CBD.
Differential DxFollowing Ultrasound: 1) Gallstone 2) Tumor: pancreatic, cholangiocarcinoma, ampullary/duodenal carcinoma or metastasis. 3) Benign or inflammatory stricture. 4) iatrogenic stricture 5) Primary sclerosing Cholangitis. 6) Primary Biliary Cirrhosis 7) Ascarasis parasitic obstruction
Discussion ... (continues ...)
User Group
ContributorTimothy Justin Miller :: Walter Reed Army Medical Center - Author Info
ReviewerAlbert V Porambo :: Civilian Medical Center - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 11659

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisAcute Pancreatitis
History54 year old male with persistent fevers, leukocytosis, and low grade abdominal pain.
FindingsDiffuse enlargement of the pancreas with blurring of margins. Stranding densities in the surrounding fat and blurring of the fat planes are also noted.
Differential DxMultiple etiologies of acute Pancreatitis include: EtOH Gallstones Metabolic Trauma (including iatrogenesis) Penetrating ulcer Malignancy
Discussion ... (continues ...)
User Group
ContributorAlex Galifianakis :: National Capital Consortium - Author Info
ReviewerAlbert V Porambo :: Civilian Medical Center - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 11112

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisGallstone Pancreatitis
History75 year old male with abdominal pain, nausea, and vomiting.
FindingsAxial CT images through the abdomen reveal cholelithiasis with a small stone in the distal common bile duct (CBD). The CBD is dilated and the pancreatic head is mildly heterogeneous. Peripancreatic fat-stranding is present as is fluid within the anterior pararenal space.
Differential DxAcute Pancreatitis
Discussion ... (continues ...)
User Group
ContributorMichael V Huppmann :: Walter Reed Army Medical Center - Author Info
ReviewerAlbert V Porambo :: Civilian Medical Center - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 9849

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisChronic Pancreatitis
History44 y/o woman presenting for follow-up of chronic GI disorder
FindingsMultiple punctate calcifications throughout the uncinate head, body and tail with associated diffuse fatty replacement. No intrapancreatic ductal dilatation is demonstrated. No abnormal areas of enhancement are present. Fatty infiltration of the liver. Calcification is demonstrated within the lower pole of the left kidney.
Differential Dx• Chronic Pancreatitis • Pancreatic Pseudocysts • Pancreatic Neoplasm
Discussion ... (continues ...)
User Group
ContributorObinna N Ugochukwu :: Uniformed Services University - Author Info
ReviewerJames G. Smirniotopoulos, M.D. :: Uniformed Services University - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 9637

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisChronic calcifying Pancreatitis secondary to alcohol abuse
History59 y/o alcoholic male complaining of nausea, vomiting, and back pain.
FindingsCalcifications overlying the left upper quadrant and extending to just past the midline on the right are seen on the abdominal radiograph, with corresponding CT images demonstrating calcifications withing the pancreatic ducts along with ductal dilatation.
Differential DxDifferential diagnosis includes: Chronic Pancreatitis Cystic fibrosis Cystadenoma/cystadenocarcinoma Costochondral calcifications
Discussion ... (continues ...)
User Group
ContributorDavid Matthew DeLonga :: Naval Medical Center Portsmouth - Author Info
ReviewerStephanie A Bernard :: Penn State University - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 9212

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisHereditary Pancreatitis
History16 year old boy being followed with serial radiographs for "hereditary pancreatic disorder."
FindingsRadiographs and CT images show large calcifications involving the pancreas
Differential DxChronic Pancreatitis - Cystic Fibrosis - Schwachmann-Diamond Syndrome Old Granulomatous Disease Vascular Calcification Fecal Material
Discussion ... (continues ...)
User Group
ContributorSteve Kao :: National Capital Consortium - Author Info
ReviewerWilliam R Carter, M.D. :: National Naval Medical Center Bethesda - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 7940

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisCholedocolithiasis with probable gallstone Pancreatitis
History46 y-o male with abdominal pain that radiates to the back.
FindingsIntrahepatic ductal dilatation with common bile duct dilatation and intraluminal stone. Peripancreatic fat stranding with calcified densities and cystic low attenuation lesions in the pancreatic head.
Differential DxObstructing stone Pancreatic head mass Sclerosing cholangitis Carolis disease
Discussion ... (continues ...)
User Group
ContributorEduardo Escobar :: Walter Reed Army Medical Center - Author Info
ReviewerElizabeth A. McGuigan :: National Naval Medical Center Bethesda - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 7823

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisChronic Pancreatitis
History60 year old white male presents with abdominal pain and jaundice. Pain is described as "deep pain in my stomach and my back." Upon further questioning, pt reveals that the pain often occurs at night, and is often worse with eating. The pt admits that he has been experiencing this pain for about 2 months, but decided to see a doctor due to a recent increase in pain. Pt admits to excessive alcohol use for several years.
Findings1. The CT findings are consistent with chronic Pancreatitis with acute exacerbation and presence of multiple pseudocysts. Thrombosis of the splenic vein with collateral circulations. 2. Moderate distinction of the intrahepatic biliary duct and marked dilatation of the extrahepatic biliary ductal system the gallbladder. The obstruction is mostly at the level of the distal common bile duct. This is either caused by the stenosis of the distal segment of the common bile duct at the level of the pancreatic head secondary due to chronic Pancreatitis and/or lesions at the ampulla causing obstruction.
Differential Dxacute exacerbation of chronic pancreatits penetrating peptic ulcer pancreatic CA aortic aneurysm mesenteric vascular obstruction/infarction
Discussion ... (continues ...)
User Group
Contributorryan a colapietro :: Naval Medical Center Portsmouth - Author Info
ReviewerMaria Flynn :: National Capital Consortium - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 5382

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisParathyroid Adenoma with hypercalcemia and secondary Pancreatitis. Hyperparathyroidism and Pancreatitis diagnosed by laboratory analysis, parathryoid adenoma by scintigraphy.
HistoryA 47-year-old man with a history of alcoholism and prior episode of Pancreatitis was admitted for anorexia, dehydration and severe abdominal pain. He denies any alcohol use in the past 6 months.
FindingsUltrasonography: Examination revealed mid-epigastric tenderness. There was a normal appearing gallbladder without calculi, sludge, pericholecystic fluid or wall thickening. The common duct measures 4 mm proximally and 5 mm distally, without choledocholithiasis. CT was also performed, which demonstrated poorly defined pancreatic margins with mesenteric stranding centered around the pancreas. There is duodenal thickening vs. peristalsis. Technicium-99M Sestamibi: On the 10-minute scan, there is thyroid uptake, but it is more prominent on the right. After 2 hours, there has been washout of Sestamibi from the thyroid tissue but a persistent focus of activity in the right lower neck.
Differential DxThe patient has a clinical picture, laboratory analysis and imaging all consistent with Pancreatitis. Differential for etiology includes: - alcohol - choledocholithiasis - chronic Pancreatitis - medications - hypercalcemic state
Discussion ... (continues ...)
User Group
ContributorJames W Graham :: Madigan Army Medical Center - Author Info
ReviewerDawn E Light :: Childrens Hospital of Dayton, OH - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 4980

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisMesenteric panniculitis; based on imaging findings, lack of other intra-abdominal inflammatory process such as Pancreatitis, renal stone, etc. as listed in the differential list.
HistoryThe patient is a 59 year-old white male with abdominal pain.
Findings“Misty” mesentery. Axial CT images of the abdomen show focal infiltration (haziness) of the left upper quadrant mesentery with resultant alteration of the normal density of the mesenteric fat. Note also the subtle halo of fat surrounding the mesenteric vessels within the area of misty mesentery, representing sparing of the perivascular spaces.
Differential DxMesenteric panniculitis Mesenteric edema (long list of etiologies, please see factoid) Lymphedema Inflammation Hemorrhage Trauma
Discussion ... (continues ...)
User Group
ContributorJason Rexroad :: Civilian Medical Center - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 4816

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisAcute Pancreatitis: CT Evaluation of a Peripancreatic Fluid Collection
History58 y/o male with a past medical history significant for chronic alcoholism
FindingsSerial CT images of the pancreas utilizing a triple-phase protocol (non-contrast, arterial (25 second delay) and venous phase (70 second delay)) demonstrate an atrophic pancreas with a significant degree of peripancreatic inflammatory changes. A anterior peripancreatic fluid collection is present which patrially encapsulates the pancreas interdigitating between the glangular fronds and providing an appearance initially concerning for pancreatic necrosis in the mid-body and pancreatic head. On close inspection of the post-contrast images, the pancreatic tissue has a normal enhancement pattern.
Differential Dxpancreatic pseudocyst pancreatic necrosis
Discussion ... (continues ...)
User Group
ContributorMichael D Wirt :: Tripler Army Medical Center - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 4370

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisAcute on chronic Pancreatitis diagnosed from laboratory and clinical information. Complications and severity clarified with CT imaging.
HistoryHistory of Pancreatitis in the past complicated by pseudocyst and hemorrhage now with recurrent Pancreatitis and decreasing hematocrit. Scan to assess for complications.
FindingsHeavy calcifications throughout the pancreas. Fluid collections and disruption of the normal fat plances around the pancreas. Pancreatic edema and enlargement. Small bowel ileus. No abscess or evidence of bacterial overgrowth.
Differential Dx
Discussion ... (continues ...)
User Group
ContributorKevin F. McCarthy :: Civilian Medical Center - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 4326

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisPleural effusion secondary to Pancreatitis
History28 year old man with epigastric pain after night of ethanol indiscretion.
FindingsFrontal and lateral chest radiograph show menisci in the left lateral and posterior costophrenic angles consistent with a unilateral pleural effusion.
Differential Dx
Discussion ... (continues ...)
User Group
ContributorJames H Chang :: National Capital Consortium - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 3215

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisCalcified gallstones and chronic calcific Pancreatitis
History50 y.o with right upper quadrant pain for 1 month
FindingsMultiple faceted Gallstones
Differential Dx
Discussion ... (continues ...)
User Group
ContributorRon Boucher :: Naval Medical Center San Diego - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 3186

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisPatient 1: Resectable carcinoma of the head of the pancreas. A Whipple procedure should be performed. Fluoroscopically-guided aspiration of the lesion and pancreatic juice cytology during ERP might be performed preoperatively in an attempt to establish a pathologic diagnosis. Patient 2: (Film 5). Chronic Pancreatitis. Patient 3: (Films 6 and 7). Pancreas divisum.
HistoryPatient 1 is 34-year-old woman with an elevated alkaline phosphatase and an elevated bilirubin. Films .1 - .3 are contrast-enhanced CT scans which demonstrates intra- and extrahepatic bile duct dilatation with an abrupt obstruction between Films .2-scan 4 and .3-scan 1 in the head of the pancreas. No mass is seen. A sonogram (not shown) showed no other findings. Film .4, left image, is an endoscopic retrograde cholangiogram and Film .4, right image, is an endoscopic retrograde pancreatogram (ERP). What is your diagnosis and what should be done next? Film .5 is an ERP on patient 2. What is your diagnosis? Films .6 and .7 are ERPs on patient 3. What is your diagnosis? (Two injections were made.)
FindingsPatient 1: (Films .1 - .4). There is anatomically contiguous encasement (stenosis) of the intrapancreatic common bile duct and the main pancreatic duct (double duct sign) which is nearly pathognomonic of pancreatic carcinoma. Neither CT or sonography showed a mass (or any evidence of spread) making this one of the rare duct cell carcinomas potentially curable by a Whipple procedure. Unfortunately, the only surgery done was a cholecystojejunostomy because no mass was seen and intraoperative biopsies were interpreted as Pancreatitis. A CT 10 months later when the cholecystojejunostomy closed off (Film .8) showed a hypodense mass (arrows) in the pancreatic head and uncinate process with loss of the fat plane between it and the inferior vena cava. It could not be peeled off the inferior vena cava at surgery and only a palliative choledochojejunostomy could be performed. Patient 2: (Film .5). The proximal (upstream) main pancreatic duct is dilated with dilated side branches. There is a long segment smooth slight narrowing in the distal main pancreatic duct (head of the pancreas) but side branches fill from this slight stricture. Patient 3: (Films .6 and .7). Film .6 is an injection of the duct of Wirsung via the major papilla which demonstrates normal branching and acinarization (parenchymal opacification) and a small main pancreatic duct in the head of the pancreas that does not communicate with the rest of the gland. Film .7 is an injection of the duct of Santorini via the minor papilla which opacifies the main pancreatic duct and normal side branches in the neck, body and tail of the pancreas. Pancreas divisum is failure of fusion of the ducts of Wirsung and Santorini resulting in drainage of the bulk of the gland via the duct of Santorini and the minor papilla. This anomaly is present in 4-11% of the population. Some authors think it predisposes towards Pancreatitis (because the minor papilla is too small to handle the output of the bulk of the pancreas) but this is controversial. On ERP the duct of Wirsung is short with a tapered terminus, normal side branches and early acinarization. This must not be mistaken for a pathologic obstruction. Opacification of the duct of Santorini via the minor papilla is confirmatory.
Differential Dx
Discussion ... (continues ...)
User Group
ContributorGastrointestinal Learning File - © ACR :: ACR Learning File® - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 3182

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisChronic Pancreatitis.
History45-year-old alcoholic male with recurrent abdominal pain radiating towards the back. Films .1 and .2 are contrast-enhanced CT scan performed after the patient recovered from a severe bout of pain. Films .3 - .6 are sonograms done 6 months later during an episode of pain. Films .3 and .4 are transverse images of the head and body of the pancreas. Film .5 is a parasagittal right anterior oblique scan of the common bile duct (calipers) which measured 6.5 mm. The stomach was filled with water for Film .6, a transverse view of the pancreas.
FindingsThe CT scans demonstrate scattered pancreatic calcifications throughout the gland, the largest in the uncinate process. This calcification (arrow) is surrounded by fluid (Film .7), proving its intraductal location. The pancreatic duct is irregularly dilated (Film .1-scans 1,2). The head and uncinate process are enlarged (Films .1-scan 3 and .7 - .9), but the mass has ductal calcifications within it consistent with an inflammatory mass. Note the inflammatory changes in the right perirenal fat (Films .1-scan 3 and .7 - .9) and the small resolving pancreatic fluid collection adjacent to the right psoas muscle on Films .8 and .9, arrow). The initial sonograms show shadowing echodensities in the head of the pancreas (Film .10, arrows), a dilated duct (calipers, 1.2 cm) in the body of the pancreas (Film .4) and a mildly dilated common duct (calipers, Film .5, 6.5 mm) but the anatomy is not well defined. After water ingestion (Film .6), multiple echodensities can be seen throughout the irregular gland with poorly demarcated hypoechoic enlargement of the head and pancreatic ductal dilatation (calipers). Calcifications (which were not noted prospectively) are barely discernible on the plain abdominal film (.5) to the left of T-11,12 and L1 corresponding to the tail of the pancreas.
Differential Dx
Discussion ... (continues ...)
User Group
ContributorGastrointestinal Learning File - © ACR :: ACR Learning File® - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 3181

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisAcute Pancreatitis.
History45-year-old man with severe abdominal pain after a bout of drinking. Serum amylase and lipase are elevated. Film .1-scan 1 is a transverse sonogram of the pancreas. Film .1-scan 2 is an oblique scan that shows the head and uncinate process of the pancreas as well as the common bile duct. Film .1-scans 3,4 are transverse and sagittal scans of the left kidney. Films .3 and .4 are contrast-enhanced abdominal CT scan performed 2 days after the sonogram.
FindingsThe pancreas is enlarged in size and inhomogeneously hypoechoic in echo texture on Film .1-scans 1,2. The common bile duct is minimally enlarged, measuring 6.1 mm. Fluid is seen as a sonolucency in the left anterior pararenal space (arrows), anterior and lateral to the left kidney on Film .5. Note the paucity of gas in the descending colon on the scout digital radiograph (Film .2). Film .3-scans 1,2 show atelectatic changes in both lung bases, L>R, with a left pleural effusion seen as a water density collection between the spleen and the posterior diaphragm. These intrathoracic abnormalities are common in patients with acute Pancreatitis. Relatively low density pancreatic fluid is seen surrounding the denser, inhomogeneously contrast-enhanced parenchyma of the pancreatic body and tail (arrows) in Film .6. This fluid extends to the posterior wall of the splenic flexure and between the left kidney and spleen, thickening Gerota's fascia. The involvement of the splenic flexure in the region of the phrenicocolic ligament is responsible for the paucity of gas in the descending colon and relative dilatation of the proximal colon (colon cut-off sign in Pancreatitis). A small amount of fluid surrounds the head of the pancreas in Film .3-scan 4, and a large amount is seen in the left anterior pararenal space. The liver is isodense with the gallbladder, indicating a fatty liver. Film .7 shows an enlarged uncinate process, thickening of Gerota's fascia on the right, and phlegmon (arrows) extending antero-inferiorly from the pancreas into the transverse mesocolon. Film .8 shows fluid in both anterior pararenal spaces and a phlegmonous mass (arrows) inferior to the uncinate process. Film .4-scans 3,4 show the most caudal extent of the fluid in the anterior pararenal spaces.
Differential Dx
Discussion ... (continues ...)
User Group
ContributorGastrointestinal Learning File - © ACR :: ACR Learning File® - Author Info
ReviewerJames G. Smirniotopoulos, M.D. :: Uniformed Services University - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 3062

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisPancreatitis.
HistoryThis 38-year-old female patient with a history of alcoholism presented with upper GI bleeding. An upper GI examination was performed (Films .1 and .2), and the duodenal films are presented for your interpretation. What are the findings and what is the differential diagnosis? An ERCP was performed (Film .3) when the barium had cleared from the GI tract. Describe the findings on the ERCP.
FindingsNOTE: FINDINGS AND DISCUSSION TEXT ARE IDENTICAL. The hypotonic examination of the duodenal loop shows an extrinsic compression defect along the second part of the inner curve of the duodenal loop. This impression has a reverse-3 configuration. Note is also made of a small diverticulum on the medial distal aspect of the second part of the duodenum. This appearance is typical of a mass in the head of the pancreas. Any mass, whether malignant or benign, in the region of the head of the pancreas will produce this impression. Invasion and destruction of the duodenal folds are the only reliable indicators of a malignant tumour. Other signs that may be seen with a mass in the head of the pancreas are an effacement of folds, or a localized extrinsic pressure defect on the inferior aspect of the duodenal bulb. The ERCP shows filling of ectatic pancreatic branch ducts in the region of the head and proximal body of the pancreas. The ducts in the head of the pancreas are stretched and the main pancreatic duct is also narrowed in the region of the head. The main pancreatic duct terminates abruptly with no filling of the distal body or tail region. In the region of the proximal body there is a small collection of contrast consistent with a pseudocyst (arrow). These findings are consistent with severe Pancreatitis with resultant enlargement of the head of the pancreas.
Differential Dx
Discussion ... (continues ...)
User Group
ContributorGastrointestinal Learning File - © ACR :: ACR Learning File® - Author Info
Reviewer :: - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
Case ID: 3002

Sample Image
Click to View

View
:: - TF Case :: Display Thumbnails - Thumbnails :: Disease Topic - Topic :: Thumbnail View
DiagnosisLesser sac abscess secondary to Pancreatitis.
HistoryThis middle-aged male presented to the Emergency Room with abdominal pain. He had a history of ethanol abuse. Supine and upright views of the abdomen (Films .1 and .2) were obtained. Review these first. The CT scan (Films .3 and .4) confirms the diagnosis.
FindingsThere is a mottled gas collection in the mid upper abdomen. On the supine film there is displacement of the bowel inferiorly around this gas collection. A CT scan demonstrates fluid and gas in the lesser sac. The tail of the pancreas has undergone liquefaction. At surgery, a large lesser sac abscess secondary to Pancreatitis was drained.
Differential Dx
Discussion ... (continues ...)
User Group
ContributorGastrointestinal Learning File - © ACR :: ACR Learning File® - Author Info
ReviewerJames G. Smirniotopoulos, M.D. :: Uniformed Services University - Editor Info
Case Accepted: 2009-07-30 21:40:44-04 :: Revised: :: Submitted:
22 Search Results for => Pancreatitis <= Result Items 1 - 20
Search More
search - Search More - (Click to Open) :: close


Use this MedPix® Visitor Feedback Form for Comments and Suggestions


MedPix® is sponsored by the Department of Radiology and Radiological Sciences, USUHS, Bethesda, MD
We do not accept paid advertisements.

This website is accredited by Health On the Net Foundation. Click to verify. We comply with the HONcode standard
for trustworthy health information:
verify here.

MedPix® is a Registered Trademark of USUHS
The MedPix® Database Engine is Patented - USPTO No. 7,080,098
Portions of MedPix® are Copyright © 1999 - 2014 by J.G. Smirniotopoulos, M.D. & H. Irvine, M.D.
The MedPix® Classification Schema Copyright © 1999 - 2014 by J.G.Smirniotopoulos,M.D.
MedPix® has displayed more than   1,103,764,222   pages since 3 September 2000.

Database Successfully Disconnected