How do acute pancreatitis appear on cross sectional imaging
What are the two major types of acute pancreatitis, and how do they appear on cross sectional imaging?
Interstitial edematous pancreatitis and necrotizing pancreatitis.
In interstitial edematous pancreatitis, diffuse or localized enlargement of the pancreas is seen, with normal homogeneous enhancement or slightly heterogeneous enhancement of the pancreatic parenchyma due to edema and inflammation. Sometimes, peripancreatic fat stranding, peripancreatic fluid, retroperitoneal fascial plane thickening, or reactive bowel wall thickening may also be seen.
Note that visualization of a normal appearing pancreas on cross-sectional imaging does not exclude the presence of acute pancreatitis.
In necrotizing pancreatitis, areas of nonenhancement are seen in the pancreas and/or surrounding peripancreatic tissues due to tissue necrosis, which may be sterile or superinfected. Presence of necrosis and larger amounts of necrosis (particularly when >30% of the pancreas) are associated with increased patient morbidity and mortality.