Acute pancreatitis

Case contributed by Dr Salahouddin Asadullah
Diagnosis almost certain

Presentation

Abdominal pain post anal growth biopsy.

Patient Data

Age: 45 years
Gender: Female
ct

There is a diffuse enlargement of pancreas with peripancreatic fat strandings and small adjacent fluid pockets. No area of parenchymal necrosis.Thickening of anterior and posterior renal fascia bilaterally.

No thrombosis or pseudoaneurysm noted.

Fatty infiltration of the liver with a small calcified focus in the lower posterior segment (VI).

No cholelithiasis. CBD is mildly prominent.

Mild pleural effusion on the left and small left basal atelectasis.

Anal growth not visualized.

No bone or lung metastasis.

Case Discussion

The patient was being worked up for anal growth and presented to the ER with abdominal pain. USG shows diffusely swollen pancreas with heterogeneous texture. Serum amylase was mildly raised(136 U/L). CT features are consistent with moderate acute interstitial pancreatitis (modified CT severity index = 4). Anal growth is not visualized on CT. No lung or bone metastasis noted. Pancreatitis is not associated with anal growth biopsy in this case and likely cause is idiopathic.

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