Assessment #3 set #1 case #9

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pancreatitis
B/L effusions

Pancreatitis

enlarged, edematous pancreas w/ assoc standing and mod vol FF.
c/w pancreatitis.

acute interstitial pancreatitis with splenic vein thrombosis

Ascites. Pleural effusion

Partial small bowel obstruction. Oral contrast is seen in the distal small bowel.
Moderate volume ascites.
Small bilateral pleural effusions with adjacent atelectasis.

lesser sac fluid predom,

Moderate bilateral pleural effusions, adjacent atelectasis.
Hepatomegaly
Edematous appearance of the pancreas diffusely, pancreatitis, no organized fluid collection

acute pancreatitis. intraperitoneal free fluid, pleural effusion and consolidations

Peripancreatic fluid, suggestive of pancreatitis. No focal collection or findings of necrosis. Correlation with lipase is recommended. There is cholelithiasis, however no CBD dilation.

Small volume ascites.

Small bilateral pleural effusions with associated atelectasis.

Fat stranding and fluid surrounding the pancreas suspicious for pancreatitis with acute peripancreatic fluid collection. Small volume ascites and small bilateral pleural effusions. Duodenitis, may be reactive in setting of pancreatitis.

asfdg

panc

Acute pancreatitis with moderate ascites.
Basal atelectasis with adjacent resorption atelectasis.
Ascites

Acute pancreatitis with associated peripancreatic inflammatory changes and peritoneal fluid.

acute interstitial edematous pancreatitis
no fluid collections
no vascular issues
pleural effusions
atelectasis

pancreqatitis

Ax pancreatitis
ascites
BL effusions and atelectasis
steatosis

Acute pancreatitis without evidence of complication. There is stranding and fluid along the pancreas with inflammatory changes along the adjacent bowel. Stranding and edema in the gallbladder fossa are favored reactive rather than related to cholecystitis. Narrowing of the splenic artery without evidence of high grde obstruction or pseudoaneurysm.
No evidence of bowel obstruction.
Small bilateral pleural effusions with adjacent atalectasis.

Diffuse peripancreatic inflammatory changes with edematous appearance of the pancreatic parenchyma, concerning for acute interstitial edematous pancreatitis. Correlate with lipase levels. No definite peripancreatic fluid collection.
Findings of fluid overload, including small bilateral pleural effusions with compressive atelectasis, moderate volume simple appearing abdominopelvic ascites, and trace pericardial effusion.
Small hiatal hernia.
Hyperattenuating material in the gallbladder, likely sludge.
Normal appendix. Focal hyperattenuating segment of distal small bowel, concerning for ischemia. No pneumatosis or portal venous gas. No bowel wall dilation to suggest obstruction. There is corresponding patchy opacification of the distal SMV branches, concerning for vascular occlusion. Recommend surgical consultation.
There is also some edema of the wall of the gastric body, as can be seen with gastritis.

Edematous pancreatitis.
Gallbladder sludge
Reactive bowel thickening.
Effusions.

intersitital pancreatitis with reactive gastritis / duodenitis, asciites, pleural effusions

Acute pancreatitis with reactive duodenitis. No drainable fluid collection.

xx

cardiomegaly
Moderate bilateral pleural effusions with passive atelectasis.
Diffuse pancreatic enlargement and inflammation – acute interstitial edematous pancreatitis.
Inflammation of the stomach secondary to pancreatitis.

Extensive fat stranding and edema surrounding the pancreas as well as free intraperitoneal fluid in the right greater than left paracolic gutter, findings are consistent with acute interstitial pancreatitis. No evidence of focal fluid collection or necrosis of pancreatic tissue.

Peripancreatic edema and fat stranding with subtle loss of normal pancreatic parenchyma. Findings favored to represent acute pancreatitis with early signs of necrosis
Bilateral pleural effusions with compressive atelectasis

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edemetaous pancreatitis with fat stranding and peripancreatic fluid

Findings/impression:
The pancreas is mildly edematous with surrounding edema and inflammatory changes. This could represent acute pancreatitis in the appropriate clinical setting. Recommend correlation with patient’s history and lipase.
Inflammatory changes are present surrounding the stomach within possible area of perforation. A couple small foci of air are present in the anterior abdominal mesentery. Recommend localization with other views.
Biliary sludge and stones are present. A focus of air is present about the anterior superior aspect of the gallbladder and could represent acute gallbladder perforation or emphysematous cholecystitis. Surrounding inflammatory changes are present.
Large air-filled diverticulum about the sigmoid colon.
Small bilateral pleural effusions with adjacent passive atelectasis.
Moderate volume ascites.
Nonspecific, increased density is present in the base of the penis and could represent acute blood in the appropriate clinical setting. Recommend correlations with patient’s history and clinical presentation.

Pancreatitis

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Acute uncomplicated interstitial oedematous pancreatitis.
Fluid in the retroperitoneum and mesenteric edema w/ adjacent duodenal wall thickening favored reactive.

Acute interstitial edematous pancreatitis without necrosis. Extensive peripancreatic free fluid and inflammation without discrete organized collection. No associated vascular complication.

Acute necrotizing pancreatitis with necrosis within the pancreatic body involving approximately 30% of the pancreatic parenchyma. Acute necrotizing collection along the body of the pancreas. No gross venous thrombosis or evidence of pseudoaneurysm. Puncatate hyperdensities within the ballbladder, possibly representing cholilithiasis with punctate intraluminal gas within the gallbladder. Recommend RUQ ultrasound for further evaluation.

Small to moderate volume of abdominopelvic ascities and fluid tracking along the anterior pararenal space, likely reactive. Reactive inflammatory changes dilation and hyperenhancement of the duodenum and ascending colon.

Acute interstitial edematous pancreatitis with surrounding peripancreatic fluid and stranding.

There are bilateral small pleural effusions resulting in passive atelectasis of both lung bases.

There is small volume free fluid in the abdomen and pelvis

panc ,reactive gastrotos duod, air in gb may reflect ascening inf

Extensive pancreatitis with ill defined loculated fluid around the pancreas and all over.

Acute pancreatitis with extensive moderate volume ascities and peritoneal thickening likely representing peritonitis.

Probable reactive ileus

gallbladder sludge vs vicarious exretion of contrast

pancreatitis

Acute necrotizing pancreatitis with necrosis of the pancreatic tail. Acute peripancreatic fluid collection. No abscess.
Small volume ascites, likely related to pancreatitis.
Bilateral small pleural effusion with adjacent compressive atelectasis. Superimposed pneumonia is also possible in the appropriate clinical setting.

Moderate bilateral pleural effusions with passive atelectasis.

Hyperdense material within the gallbladder likely gallbladder sludge.

Enlarged and edematous pancreas with nonenhancing parenchymal hypodense areas suggestive of necrotizing pancreatitis. Emergent surgical consultation is recommend.

Wall thickenening/edema of the greater curvature of the stomach likely secondary inflammation.

Moderate volume ascites.

Acute interstitial edematous pancreatitis without evidence of walled off necrosis. Diffuse bowel wall thickening, likely reactive. Atelectasis and pleural effusions.