Acute pancreatitis

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis certain


Abdominal pain, nausea and vomiting.

Patient Data

Age: 60 years
Gender: Male

The pancreas is swollen with smoothing of its contour. The pancreas shows non-enhancing area and intra-parenchymal fluid in neck and body of the pancreas. Moderate ascites is seen in the abdomen. Minimal air is seen in retroperitoneum behind the pancreas in between SMA and aorta. The large bowel is distended and loaded with fecal matter. The intrahepatic ducts and CBD are minimally dilated. The gallbladder is slightly distended showing wall enhancement.


Case Discussion

The diagnosis of acute pancreatitis Grade E according to CT severity index (CTSI) with areas of intraparenchymal fluid collection and necrosis as well as peripancreatic fluid is suggested radiologically, confirmed by laboratory results of markedly elevated lipase enzymes.

Pneumoretroperitoneum is noted which is not common in pancreatitis so the possibility of a complication such as duodenal perforation may be suggested. 


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