Ultraschall Med 2016; 37 - P1_11
DOI: 10.1055/s-0036-1587921

Ultrasound aspects in acute pancreatitis

C Ciocea 1, M Danila 1, A Popescu 1, F Bende 1, R Sirli 1, I Sporea 1
  • 1University of Medicine and Pharmacy "Victor Babes", Department of Gastroenterology and Hepatology, Timisoara, Romania

Acute pancreatitis is a pathology with an unpredictable evolution that can lead to serious complications with extremely fast dynamics.

The aim of this paper is to evaluate the role of abdominal ultrasound in the diagnosis and monitoring of acute pancreatitis, but also in highlighting some ultrasound changes suggestive for moderate or severe forms of acute pancreatitis.

Material and method: We performed a retrospective study in which were enrolled 343 patients with acute pancreatitis (56.2% men and 43.8% women), mean age 56.7 ± 17.9, admitted between January 2014 – December 2015. We followed: the etiology of acute pancreatitis and the role of ultrasound in the diagnosis of biliary pancreatitis, ultrasound changes over the evolution of the disease: ascites, hyperecougenous omental bursa, peripancreatic fluid, areas of pancreatic necrosis and also the clinical condition of the patient.

Results: 58% of cases presented biliary etiology – suggestive ultrasound chnages: gallstones, obstructive jaundice, followed by ethanolic etiology (15.8%) and acute pancreatitis due to hypertriglyceridemia (6.4%). Other causes (˜ 20%) were postERCP acute pancreatitis, non-A non-B, pancreas divisum etc.

Transabdominal ultrasound detected changes in 94 patients (27.5%): ascites, hyperecougenous omental bursa, peripancreatic fluid, areas of pancreatic necrosis. In all other cases (72.5%), pancreas had normal ultrasound appearance or could not be evaluated by ultrasound.

Of the 94 cases with ultrasound changes, 12 (12.7%) progressed to severe forms of acute pancreatitis with development of organ failure.

Conclusions: In our study, the most common etiology of acute pancreatitis was biliary followed by alcohol consumption.

Ultrasonographic changes in acute pancreatitis (ascites, hyperecougenous omental bursa, peripancreatic fluid, areas of pancreatic necrosis) were present in 27.5% of cases.

Evaluation of the pancreas in acute pancreatitis can be difficult (in 41% of cases, the pancreas was not visible in ultrasound) due to associated conditions (meteorism, poor visualization of the pancreas, abdominal pain).