Diagnostic ultrasound ( PDFDrive )

220 PART II Abdominal and Pelvic Sonography
Dorsal duct
Stomach
P
Ventral duct
A
Drainage via minor papilla only
Dorsal or Santorini
FIG. 7.20 Potential Space of Lesser Peritoneal Sac. Transverse
image demonstrates the potential space of the lesser peritoneal sac
between the stomach (arrow) and pancreas (P).
B
Ventral or Wirsung
Pancreas divisum
FIG. 7.18 Pancreatic Ductal Variants With Secretions Entering
Duodenum via Minor Papilla. (A) Minor papilla only. Ventral duct
from pancreatic head empties into the dorsal duct instead of the duodenum.
(B) Pancreas divisum lacks formation of the main adult duct
because the ducts from each pancreatic anlage did not fuse. The duct
from the dorsal anlage remains separate from the main duct in the head.
This anatomic variant is present in 5% to 10% of the population.
FIG. 7.21 Peritoneal Relections and Transverse Mesocolon. Transverse
mesocolon (yellow arrow) arises from the anterior pancreas and
duodenum, formed by the parietal peritoneum that invests the pancreas
and duodenum. The transverse mesocolon invests the transverse colon
and forms part of the posterior limits of the lesser peritoneal sac (blue
arrow).
FIG. 7.19 Normal Pancreatic Duct. Transverse image of the pancreas
shows the appearance of the pancreatic duct as a linear, collapsed
structure in the body (arrows).
he clinical spectrum of acute pancreatitis ranges from a
benign, self-limited disorder (75% of patients) to severe pancreatitis
that may be fulminant and quickly cause death from
multiorgan failure. 30 Mild acute pancreatitis generally resolves
spontaneously with supportive management. Acute interstitial/
edematous pancreatitis results in an enlarged and congested gland
without appreciable necrosis or hemorrhage. 31 Banks and
Freeman 32 found that the overall mortality of pancreatitis is
approximately 5%. Mortality in the irst 2 weeks usually results
from organ failure, and ater that, from infection. Mortality was