Acute pancreatitis with incidental pancreatic lipoma

Case contributed by Dr Hani Salam


Abdominal pain and high lactate.

The pancreas is swollen, associated with extensive peripancreatic stranding and fluid in the lesser sac, extending to the pararenal spaces, more on the left side, with minimal perisplenic and perihepatic free fluid. A very small part of the head of the pancreas appears to be less enhancing compared to the rest of the gland suspicious for necrosis. No gas locule can be seen seen in the pancreas. No walled off collection or pseudocysts can be seen. 

There is a small hypodense, well denfine, non enhancing lesion seen in the tail of the pancreas. 

Gall bladder contains radiopague stones in the neck, with no overt CT features of acute cholecystitis. The celiac and SMA appear patent. No splenic artery psuedoaneurysm. 

Portal, splenic and SM veins are patent, with no evidence of thrombosis. 

Left sided pleural effusion (minimal) and associated basal collapse/consolidation. 

Interpretation: Features of acute pancreatitis, likely due to cholelethiasis. A small hypoenhancing pancreatic head portion is suggestive of necrosis. Small, unenhancing hypodense pancreatic tail lesion could represent a small cyst (pseudocyst is though less likely given the timing of the CT since the symptoms) or other lesions, such as lipoma, but needs further evaluation once the patient clinically improves. 




Acute pancreatitis.

Loss of signal in the lesion mentioned in the CT, in keeping with pancreatic lipoma. 

Case Discussion

Acute pancreatitis with incidental pancreatic tail lipoma.

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Case information

rID: 10190
Case created: 20th Jul 2010
Last edited: 10th Dec 2016
Inclusion in quiz mode: Included

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