Intra-operative sonography of pancreas
45 year old male with chronic pancreatitis, MRCP revealed lower CBD stricture and Pancreatic duct obstruction. CBD and Pancreatic duct stenting was technically not possible at ERCP. Patient is taken for Puestow's Procedure.
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Intra-operative sonography of pancreas and lower end of CBD has been done.
It reveals dilated CBD; No mass lesion at the lower end.
During the exposure of the pancreas pus came out on the pancreatic surface.
Pancreatic sonography reveals - The diameter of pancreatic duxt = 4.1mm. Caliber on MRCP was 11mm.
Debris is seen within the pancreatic duct - representing infected contents.
Since the caliber of pancreatic duct was only 4.1mm - pancreatico- jejunostomy was abandoned and only a choledocho-duodenostomy performed.
Patient is recovering well after the surgery.
Note the dense pancreatic parenchymal calcifications of Chronic pancreatitis.