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Gallstone pancreatitis

Case contributed by John Li
Diagnosis almost certain

Presentation

6 hours history of sudden onset epigastric pain radiation to the back. No signficant past medical or surgical history. Denies recent alcohol overuse.

Patient Data

Age: 50 years
Gender: Male
ct

Marked inflammatory stranding and fluid around the length of the pancreas.

Calculus is seen at the proximal main pancreatic duct near the major duodenal papilla.

No dilatation of the main pancreatic duct.
Mild dilatation of the common bile duct to 7 mm. 

No intrahepatic duct dilatation.
Radiodense cholelithiasis present.

Features consistent with acute pancreatitis. Cholelithiasis and a calculus present at the proximal main pancreatic duct near the major duodenal papilla is the likely cause for the pancreatitis

Case Discussion

Because of elevated bilirubin this patient proceeded to have an ERCP with sphincterotomy and placement of common bile duct and pancreatic stents.

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