Acute pancreatitis

Case contributed by Nikhil Rao , 15 Oct 2010
Diagnosis almost certain
Changed by Henry Knipe, 18 May 2015

Updates to Case Attributes

Title was changed:
Acute severe pancreatitis
Presentation was changed:
30 year old male with epigastricEpigastric pain, radiating to the back.
Gender was set to Male.
Age was set to 30.
Body was changed:

This patient was 5 days post laparascopiclaparoscopic cholecystectomy after an attack of biliary colic and was admitted with severe epigsatricepigastric pain and tenderness.

CT of the abdomen demonstrates bilateral pleural effusions with basal atelectasis. Within the abdomen there is ascites with fluid seen superior to the liver. The pancreas appears swollen but does enhance uniformly and there is significant oedema in the peri-pancreatic and retro-peritoneal fat throughout the abdomen. The free fluid is seen tracking to a collection within the pelvis. No definite abscess or pseudocyst collection seen. There is hydronephrosis of the atrophic right kidney. Left nephrectomy noted. The transplant kidney is in the right iliac fossa and is unobstructed. Gas is seen throughout the colon and small bowel in keeping with an ileus but no definite bowel obstruction.

The The features are in keeping with acute pancreatitis.

He He was treated conservatively on the ward in the HDU.

  • -<p>This patient was 5 days post laparascopic cholecystectomy after an attack of biliary colic and was admitted with severe epigsatric pain and tenderness.</p><p>CT of the abdomen demonstrates bilateral <a title="Pleural effusion" href="/articles/pleural-effusion">pleural effusions</a> with basal <a title="atelectasis" href="/articles/atelectasis">atelectasis</a>. Within the abdomen there is <a title="ascites" href="/articles/ascites">ascites</a> with fluid seen superior to the liver. The pancreas appears swollen but does enhance uniformly and there is significant oedema in the peri-pancreatic and retro-peritoneal fat throughout the abdomen. The free fluid is seen tracking to a collection within the pelvis. No definite <a title="intraperitoneal abscess" href="/articles/intraperitoneal-abscess">abscess</a> or <a title="Pancreatic pseudocysts" href="/articles/pancreatic-pseudocyst-1">pseudocyst</a> collection seen. There is <a title="hydronephrosis" href="/articles/hydronephrosis">hydronephrosis</a> of the atrophic right kidney. Left nephrectomy noted. The transplant kidney is in the right iliac fossa and is unobstructed. Gas is seen throughout the colon and small bowel in keeping with an ileus but no definite bowel obstruction.</p><p>The features are in keeping with severe of <a title="Acute pancreatitis" href="/articles/acute-pancreatitis">acute pancreatitis</a>. </p><p>He was treated conservatively on the ward in the HDU.</p>
  • +<p>This patient was 5 days post laparoscopic cholecystectomy after an attack of <a title="biliary colic" href="/articles/biliary-colic">biliary colic</a> and was admitted with severe epigastric pain and tenderness. The features are in keeping with <a href="/articles/acute-pancreatitis">acute pancreatitis</a>. He was treated conservatively on the ward in the HDU.</p>

Tags changed:

  • renal transplant

Updates to Study Attributes

Findings was added:

Within the abdomen there is ascites with fluid seen superior to the liver. The pancreas appears swollen but does enhance uniformly and there is significant oedema in the peri-pancreatic and retro-peritoneal fat throughout the abdomen. The free fluid is seen tracking to a collection within the pelvis. No definite abscess or pseudocyst collection seen.

There is hydronephrosis of the atrophic right kidney. Left nephrectomy noted. The transplant kidney is in the right iliac fossa and is unobstructed. Gas is seen throughout the colon and small bowel in keeping with an ileus but no definite bowel obstruction.

Images Changes:

Image CT (C+ portal venous phase) ( update )

Perspective was set to Axial.
Specifics changed from to C+ portal venous phase.
Description was removed:
There are bilateral pleural effusions with basal atelectasis. Within the abdomen there is ascites with fluid seen superior to the liver. The pancreas appears swollen but does enhance uniformly and there is significant oedema in the peri-pancreatic and retro-peritoneal fat throughout the abdomen. The free fluid is seen tracking to a collection within the pelvis. No definite abscess or pseudo cyst collection seen. There is hydronephrosis of the atrophic right kidney. Left nephrectomy noted. The transplant kidney is in the right iliac fossa and is unobstructed. Gas is seen throughout the colon and small bowel in keeping with an ileus but no definite bowel obstruction.

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