EURORAD ESR

Case 10819

Emphysematous pancreatitis with concomitant splanchnic vein thrombosis

Author(s)
Ines Leite, Pedro Santos, Fátima Pires, Isabel Távora

Hospital de Santa Maria;
Rua Soeiro Pereira Gomes, n1,
7A 1600 Lisboa, Portugal;
Email:inex.leite@gmail.com
 
Patient
female, 76 year(s)
 
 
  • Figure 1
    AP chest X-ray and abdominal CT scout view of abdomen.

    The presence of mottled gas (circle) overlying the upper quadrants of the abdomen was evident in both techniques.

     
    Area of Interest: Abdomen; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 2
    Axial CT images: lung (A), soft tissue (B,C) windows.

    Necrotising pancreatitis with almost the entire parenchyma lacking contrast enhancement and being replaced by mottled gas. The latter was also visualised within the main pancreatic duct (arrow A) and the...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 3
    Axial CT image.

    The gallbladder was well-distended and there was no evidence of radiodense calculi or wall thickening. A moderate amount of fluid was detected.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 4
    Arterial phase coronal CT image (A).

    The coeliac trunk and the superior mesenteric artery were permeable.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 5
    Portal venous phase CT images (A-C).

    CT reformations better depict splenic vein (red arrow), superior mesenteric vein (yellow arrow) and portal vein (asterisk) thrombosis. There was no evidence of portomesenteric gas.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
The presence of mottled gas (circle) overlying the upper quadrants of the abdomen was evident in both techniques.
 
Necrotising pancreatitis with almost the entire parenchyma lacking contrast enhancement and being replaced by mottled gas. The latter was also visualised within the main pancreatic duct (arrow A) and the peripancreatic necrotic collections (*).
 
The gallbladder was well-distended and there was no evidence of radiodense calculi or wall thickening. A moderate amount of fluid was detected.
 
The coeliac trunk and the superior mesenteric artery were permeable.
 
CT reformations better depict splenic vein (red arrow), superior mesenteric vein (yellow arrow) and portal vein (asterisk) thrombosis. There was no evidence of portomesenteric gas.
 
 
 
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