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Acute Pancreatitis

Faye C Laing, MD

March 28, 1994

Presentation

The patient presented with recurrent episodes of midepigastric pain.

Imaging Findings

Transverse Ultrasound

Single transverse image shows that pancreatic echogenicity is within normal limits, but the gland is mildly enlarged. In addition, a complex fluid collection (arrow) lies anterior to the pancreas, and abnormal sonolucency (arrow) surrounds the splenic vein.

Diagnosis

Acute pancreatitis

Discussion

These sonographic findings are due to complications of acute pancreatitis with fluid in the lesser sac and perivascular inflammation surrounding the splenic vein. These vascular changes frequently extend into the superior mesenteric and/or portal veins. Because venous thrombosis may be a sequellae of acute pancreatitis, careful follow-up examinations (with color Doppler) should be done to look for this potential complication. Interestingly, as in this case, some patients with acute pancreatitis show more inflammatory changes outside of the gland than within the substance of the pancreas.

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