Acute Pancreatitis

Acute inflammation of pancreas with variable involvement of other regional tissues or remote organs.

Causes: Most common are biliary tract calculi and alcohol abuse. 

US: examination is more beneficial, 48 hours after the acute episode as the paralytic ileus resolves.

Atlanta Classification for Acute Pancreatitis
The revised classification system also updates confusing and sometimes inaccurate terminology that was previously used to describe pancreatic and peripancreatic collections. As such, use of the terms acute pseudocyst and pancreatic abscess is now discouraged. 

Interstitial edematous pancreatitis (70-80% of cases)
Normal enhancement of pancreas without necrosis. 
Pancreas typically enlarged and edematous with loss of normal fatty lobulation. 
Peripancreatic fat stranding, edema, and free fluid.
Mild edematous pancreatitis can appear normal on CT.

Four distinct collection subtypes are identified on the basis of the presence of pancreatic necrosis and time elapsed since the onset of pancreatitis.

Acute peripancreatic fluid collections (APFCs) and pseudocysts occur in interstitial edematous pancreatitis (IEP) and contain fluid only. 

Acute necrotic collections (ANCs) and walled-off necrosis (WON) occur only in patients with necrotizing pancreatitis and contain variable amounts of fl uid and necrotic debris.

US_ PANCREAS: se observa incremento del tamaño del páncreas, a predominio de la cabeza y el cuerpo, contornos irregulares, signos asociados con pancreatitis aguda (pancreatitis edematosa intersticial sin colecciones).


US_ Pancreas: se observa incremento a predominio de la cabeza y el cuerpo, ecogenicidad del parénquima ligeramente heterogéneo, además de presencia colecciones anecogénicas peripancreáticas; signos en relaciona con pancreatitis aguda (pancreatitis edematosa intersticial con colección de fluido peripancreatico agudo). 


Necrotizing pancreatitis (20-30% of cases)
Areas of parenchymal necrosis which are either nonenhancing or severely hypoenhancing.
Differentiate cases with ≤ 30% necrosis from > 30% necrosis for patient prognosis. 
Necrosis may not be present initially, but can develop 3-4 days after symptom onset.





Información dirigida a estudiantes y profesionales de ciencias de la salud, como gastroenterología y radiología.