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Vascular surgeon, radiologist

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Computed tomography of the pancreas

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Acute and chronic pancreatitis

The manifestation of acute pancreatitis can be acute interstitial edema of the pancreas. At the same time, the pancreas is visualized with indistinct contours in computed tomography without a typical cellular structure. Often around the pancreas, hypodense fluid (exudate) and edema of connective tissue are determined. As the destructive process spreads, hemorrhagic pancreatitis and pancreatonecrosis develop, which is a poor prognostic sign.

Chronic pancreatitis or slowly progresses, or occasionally recurs. There are two main causes of chronic pancreatitis - alcohol and choledocholithiasis.

Typical signs of chronic pancreatitis are fibrosis, multiple calcifications, uneven expansion of the pancreatic duct and the formation of pseudocysts in the parenchyma or near the pancreas. In the late stages of the disease, atrophy of the gland often develops. It is possible that pancreatic cancer arises precisely against a background of chronic ossifying pancreatitis, but this issue is still being studied.

Neoplasms of the pancreas

Pancreatic cancer is most often localized in the gland's head. Therefore even small tumors cause cholestasis (stagnation of bile) due to obstruction of the common bile duct. Pancreatic cancer is prone to early metastasis in the liver and regional lymph nodes. In doubtful cases, retrograde cholangiopancreatography is used to evaluate the pancreatic and common bile duct. Neoplasms of islet cells are usually located in the area of the body of the pancreas, 75% of the tumors are functionally active. With tumors of gastrin-producing cells, Zollinger-Ellison syndrome develops. There are a number of new pancreatic neoplasms - insulinoma, glucagonum and serotonin-producing tumor.

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