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CT ABDOMEN (TRIPHASIC PANCREAS), Including Detailed Report. (Necrotizing Pancreatitis)


Report: CT ABDOMEN (TRIPHASIC PANCREAS).


ClNICAL INFO: Recurrent pancreatitis, nausea, vomiting.


TECHNIQUE: 2.0 mm reconstructed images from a scan performed on multi slice CT scan reviewed on workstation. Non-enhanced and post contrast tri-phasic CT abdomen performed in arterial, venous and delayed phases according to departmental protocol.


FINDINGS:

  • There is evidence of peripancreatic collection approximately measuring 4.8x7.7x11.7cm in AP x TR x CC dimensions with approximate volume of 216mL. This collection is extending retroperitoneal region at level of L4 vertebra. There is collection anterior to pancreatic head measuring 5x3cm. Peripancreatic fluid is noted along pancreatic body and tail extending along greater curvature of stomach as well.
  •  There is thickening of left perirenal fascia and mesenteric root fat stranding.
  • No evidence of splenic artery erosion or pseudo-aneurysm is noted. There is compression of splenic vein however no evidence of intraluminal thrombus is noted.
  • Mild left sided pleural effusion and atelectasis noted on left side.
  • The liver has smooth margins. There is no focal hepatic mass lesion. Hepatic vessels are patent.
  • Gallbladder is normal without any radio opaque calculus or pericholecystic strandy changes. 
  • BD is normal in caliber without any radio opaque calculus or biliary dilatation.
  • Spleen is normal in size showing normal enhancement.
  • Bilateral adrenal glands are normal in size without definite nodule.
  • Bilateral kidneys show normal enhancement. There is no radio opaque calculus, mass or hydronephrosis.
  • Ureters are normal in caliber.
  • Urinary bladder and rest of the visualized pelvic viscera appear unremarkable.
  • The stomach, small and large bowel loops show no significant abnormality. Ileocecal junction is normal.
  • There is no pneumoperitoneum or features of obstruction.
  • There is no significant abdomino-pelvic lymphadenopathy or ascites
  • No definite destructive osseous lesion is seen. 
IMPRESSION:
  • Above described findings likely represent necrotizing pancreatitis with peripancreatic fluid collection. 
  • No evidence of vascular erosion, pseudo-aneurysm or thrombosis noted.
  • Mild left pleural effusion with basal atelectasis.
  • CT severity index of pancreatitis is 07/10 suggesting severe necrotizing pancreatitis.

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