- Age: 42
- Gender: Male
- Medical history: Recurrent upper gastrointestinal bleeding (six times). No current medication.
- Intoxications: 7-8 EH alcohol per day.
- Initial presentation: Acute pain upper abdomen.
- Examination: Pressure pain upper abdomen, active muscular resistance.
S. Spijkers & M. Maas
Checklist CT (Abdomen)
- Abdominal wall:
- (Especially periumbilical and inguinal regions) hernias, enlarged lymph nodes?
- Liver and spleen:
- Homogeneous parenchyma without focal lesions?
- Well-defined surfaces?
- Well-defined, thin wall?
- Pancreas, adrenals:
- Well-defined, size normal?
- Any intraperitoneal/retroperitoneal fat?
- Kidneys, ureter and bladder:
- Symmetric excretion of CM?
- Obstruction, atrophy, bladder wall smooth and thin?
- Reproductive organs:
- Uniform prostate of normal size?
- Spermatic cord, uterus, ovaries?
- Normal thickness of walls?
- Stenoses or dilations?
- Vessels: aneurysms? thromboses?
- Enlarged lymph nodes?
- Bone window:
- Lumbar spine and pelvis: degenerative lesions? Fractures?
- Focal sclerotic or lytic lesions?
- Spinal stenoses?
In acute pancreatitis contrast-enhanced CT is the imaging modality of choice if the diagnosis is unclear and/or to assess disease severity and complications. Below the CT findings which can be seen in acute pancreatitis.
CT findings acute pancreatitis – Abnormalities that may be seen in the pancreas include:
- Focal or diffuse parenchymal enlargement
- Changes in density because of edema
- Indistinct pancreatic margins owing to inflammation
- Surrounding retroperitoneal fat stranding
- Liquefactive necrosis of pancreatic parenchyma
- Lack of parenchymal enhancement
- Often multifocal
- Infected necrosis
- Difficult to distinguish from aseptic liquefactive necrosis
- Presence of gas is helpful
- FNA helpful
- Abscess formation
- Circumscribed fluid collection
- Little or no necrotic tissues (thus distinguishing it from infected necrosis)
- High-attenuation fluid in the retroperitoneum or peripancreatic tissues