Presentation
Severe epigastric pain radiating to left loin as well as vomiting.
Patient Data
The swollen pancreatic tail shows hypoenhancement in the arterial and portal phase with mild homogenous enhancement in the delayed phases. Blurring of the surrounding fat planes is also seen extending to the left retroperitoneal and anterior pararenal spaces with associated thickening of the Gerota and lateral conal perirenal fascia. No peripancreatic fluid accumulation or evidence of parenchymal necrosis is noted in the current study. Blurring of the left pericolic fat planes and small regional lymph nodes are also noted.
The lower chest cuts show bilateral lower lung lobe segmental consolidation with reticulations and associated mild pleural effusion.
Case Discussion
Features on CT scan in correlation with physical exam findings and elevated amylase and lipase tests, suggestive of focal acute pancreatitis. This is an uncommon presentation of acute pancreatitis that is usually diffuse, the following should be considered:
- focal autoimmune pancreatitis
- underlying pancreatic tail pathology presenting acutely as inflammation like pancreatic neoplastic lesion, duct stricture causing compromise of the bile drainage and subsequent inflammation.
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