Presentation
Male with known chronic liver disease secondary to alcohol use, now presents with abdominal pain, nausea and vomiting.
Patient Data
There is moderate and diffuse peripancreatic fat stranding. There is a moderate volume of free intraabdominal fluid, with pockets scattered through the mesentery and pooling in the paracolic gutters. The adjacent second and third segments of the duodenum demonstrate mural thickening, in keeping with reactive change.
Multiple prominent small mesenteric lymph nodes.
The liver demonstrates diffuse low attenuation in keeping with hepatic steatosis. Within the limits of a non contrast study, spleen, adrenals, kidneys are normal. No free intraabdominal gas. No destructive bone lesions. T9 and T11 vertebral body compression fractures are longstanding.
The colon demonstrates fatty mural change which is unaltered from the previous CT, consistent with prior inflammation.
Case Discussion
The diagnosis of acute pancreatitis was confirmed biochemically with markedly elevated lipase.
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