Radiology Teaching Files > Case 5317601

Contributed by: Residents and Faculty Baptist Health System Birmingham Alabama.
Patient: 70 year old male
History: Alcoholic with abdominal pain

Fig. 1

Fig. 2

Dilatation of the pancreas can be seen. This patient also has a small pseudocyst. These may develop as early as 2 days after onset of pancreatitis and complicates about 10% of cases.

Diagnosis: acute pancreatitis with pseudocyst

Alcoholism and biliary tract disease cause the majority of cases of pancreatitis in the United States. Other causes include hypercalcemia, Type I and Type IV hyperlipidemia, viral infection (mumps and hepatitis), mononucleosis, drugs, trauma, penetrating gastric ulcer and structural abnormalities (i.e., pancreas divisum) in children. Trauma, systemic diseases and drugs are most common. At least 20% of patients have no predisposing condition.
CT findings vary with severity. 20-30% of patients will have a normal CT scan. Disease may be focal or diffuse. The attenuation of the involved areas of pancreas is decreased. Focal abnormality in the head of the pancreas is best differentiated from neoplasm on clinical grounds. Since there is no pancreatic capsule, spreading inflammation can involve the peripancreatic soft tissues. Spread occurs into the region of the lesser sac and left anterior pararenal space. Posteriorly spread is limitied by Gerota's Fascia. The perinephric fat stands out on plain film and is the basis of the "renal halo" sign. The bowel mesentery can also be involved. Dilation of the pancreatic duct can be seen.

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Additional Details:

Case Number: 5317601Last Updated: 07-13-2006
Anatomy: Gastrointestinal (GI)   Pathology: Non-Infectious Inflammatory Disease
Modality: CTExam Date: Access Level: Readable by all users
Keywords: acute pancreatitis, pancreatic pseudocystACR: 772.291

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