tailieunhanh - Ebook Ultrasonography of the pancreas (edition): Part 2

(BQ) Part 2 book "Ultrasonography of the pancreas" presents the following contents: Pancreatitis and pseudocysts, solid pancreatic tumors, cystic pancreatic tumors, rare pancreatic tumors, imaging correlation, pancreatic lesions - pathologic correlations, clinical and imaging scenarios, flowcharts in pancreatic diseases. | Pancreatitis and Pseudocysts 7 Steffen Rickes and Holger Neye Introduction Ultrasonography US is a noninvasive imaging modality which is often the first imaging technique in the evaluation of patients with pancreatic diseases. It has undergone significant advances in recent years. In this chapter the value of US in the diagnosis of pancreatitis and pseudocysts will be described and discussed. The article is focused on B-mode US Doppler sonography and contrast-enhanced ultrasound CEUS . Acute Pancreatitis Acute pancreatitis is a common disease that affects about 300 000 patients per year in America with a mortality of about 7 1 . The diagnosis is based on clinical and laboratory evaluation. The clinical course of acute pancreatitis varies from a mild transitory form to a severe necrotizing disease. Most episodes of acute pancreatitis are mild and self-limiting. Patients with mild pancreatitis respond well to medical treatment requiring little more than intravenous fluid resuscitation and analgesia. In contrast severe pancreatitis is defined as pancreatitis associated with organ failure and or local complications such as necrosis abscess formation or pseudocysts. Severe pancreatitis can be observed in about 20 of all cases and requires intensive care and sometimes surgical or radiologic intervention. Early S. Rickes El Department of Internal Medicine AMEOS Hospital St. Salvator Halberstadt Germany e-mail rickes@ M. D Onofrio ed. Ultrasonography of the Pancreas Springer-Verlag Italia 2012 correct assessment of the etiology and the severity of acute pancreatitis allows distinct therapeutic algorithms and can result in better outcome 1 . Advances in imaging modalities have revolutionized the management of patients with acute pancreatitis over the past decade. Contrast enhanced computed tomography CT is the criterion standard for diagnosing pancreatic necrosis and peripancreatic collections as well as for grading acute pancreatitis by the .