9%20ECOGRAFIA%20ABDOMINAL%20COMO%20CUANDO%20DONDE

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ABDOMINAL ULTRASOUND
cd
A
B
Figure 5.8 (A) Focal acute pancreatitis in the head of the pancreas. The CBD is obstructed by a hypoechoic mass in
the head, with blood clots and debris within the duct. The differential diagnosis was malignancy. (B) The same patient
8 months later. The acute inflammation has resolved, the obstruction is relieved and the pancreas now appears
hyperechoic with a mildly dilated duct, consistent with chronic pancreatitis.
a previous history of pancreatitis and a normal CA
19–9 tumour marker level.
Because malignant lesions are frequently surrounded
by an inflammatory reaction, biopsy is
also of questionable help in differentiation of focal
benign and malignant lesions.
abdomen is thrown against the seat belt, resulting
in laceration, often at the neck of the pancreas. The
duct may be ruptured, with consequent leakage of
Cysts
Benign cysts in the pancreas are rare (Fig. 5.9)
and tend to be associated with other conditions
such as polycystic disease, cystic fibrosis or von
Hippel–Lindau disease (an autosomal dominant
disease characterized by pancreatic and renal cysts,
renal carcinoma, phaeochromocytoma and/or
haemangioblastomas in the cerebellum and spine).
The presence of a cystic mass in the absence of
these conditions should raise the suspicion of one
of the rarer types of cystic carcinoma, or a pseudocyst
associated with acute pancreatitis.
TRAUMA OF THE PANCREAS
The pancreas is particularly vulnerable to ‘blunt’
trauma in road traffic accidents, in which the upper
Figure 5.9 Tiny cyst in the body of the pancreas. This
was confirmed on CT and remained stable over a period
of 2 years.