Pseudopancreatitis
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At the time the article was created Craig Hacking had no recorded disclosures.
View Craig Hacking's current disclosuresAt the time the article was last revised Jeremy Jones had no recorded disclosures.
View Jeremy Jones's current disclosuresPseudopancreatitis refers to the presence of fluid in or around the pancreas in the setting of trauma but in the absence of direct signs of traumatic pancreatic injury. Most patients will have a normal serum lipase level, but amylase has a limited sensitivity and specificity for pancreatic trauma 3.
It is thought to be secondary to aggressive fluid resuscitation of hypovolaemic shock following potential trauma-related pancreatic ischaemia 2, particularly when the time between the injury and cross-sectional imaging is prolonged 1. Hence it is associated with other signs of resuscitation of hypotension namely periportal oedema, a dilated inferior vena cava and small bowel oedema.
Differential diagnosis
- pancreatitis due to trauma
- chronic pancreatitis
- retroperitoneal fluid or haemorrhage tracking from other retroperitoneal structures
References
- 1. Brook OR, Fischer D, Militianu D, Eran A, Guralnik L, Israelit S, Engel A. Pseudopancreatitis in trauma patients. AJR. American journal of roentgenology. 193 (3): W193-6. doi:10.2214/AJR.08.1822 - Pubmed
- 2. Martin L. Gunn. Pearls and Pitfalls in Emergency Radiology. ISBN: 9781139619899
- 3. Degiannis E, Glapa M, Loukogeorgakis SP, Smith MD. Management of pancreatic trauma. Injury. 39 (1): 21-9. doi:10.1016/j.injury.2007.07.005 - Pubmed
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