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Computed tomography of the pancreas
Last reviewed: 04.07.2025
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Acute and chronic pancreatitis
Acute pancreatitis may manifest itself as acute interstitial edema of the pancreas. In this case, the pancreas is visualized with fuzzy contours during computed tomography, without the cellular structure typical for it in the norm. Hypodense fluid (exudate) and edema of connective tissue are often determined near the pancreas. As the destructive process spreads, hemorrhagic pancreatitis and pancreatic necrosis develop, which is a poor prognostic sign.
Chronic pancreatitis either progresses slowly or recurs episodically. There are two main causes of chronic pancreatitis - alcohol abuse and choledocholithiasis.
Typical signs of chronic pancreatitis are fibrosis, multiple calcifications, uneven dilation 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 occurs precisely against the background of chronic ossifying pancreatitis, but this issue is still being studied.
Neoplasms of the pancreas
Pancreatic cancer is most often localized in the head of the gland. Therefore, even small tumors cause cholestasis (stagnation of bile) due to obstruction of the common bile duct. Pancreatic cancer is prone to early metastasis to the liver and regional lymph nodes. In doubtful cases, retrograde cholangiopancreatography is performed to evaluate the pancreatic and common bile duct. Neoplasms of islet cells are usually located in the body of the pancreas, 75% of tumors are functionally active. Zollinger-Ellison syndrome develops with tumors of gastrin-producing cells. A number of other neoplasms of the pancreas are distinguished - insulinoma, glucagonoma and serotonin-producing tumor.
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