Computerized tomography chronic pancreatitis

This is an automatically translated article.


Posted by Resident Doctor, Master Tran Duc Tuan - Department of Diagnostic Imaging - Vinmec Central Park International General Hospital

Today, the excessive use of alcohol can lead to an extremely dangerous disease and harmful to the health of the patient, which is chronic pancreatitis. For timely detection and effective treatment, it is necessary to support the technique of computed tomography pancreatitis for very specific images of chronic pancreatitis and to support doctors in diagnosing. great number of.

1. Chronic pancreatitis


Chronic pancreatitis is defined as a condition of stones in the pancreas, there are many different causes leading to this condition but in which excessive alcohol use is the leading cause. Chronic pancreatitis causes gradual fibrosis of the pancreatic parenchyma, until the pancreatic parenchyma is necrotic and functional in the patient's digestive system. Primary chronic pancreatitis with calcification occurs more commonly in men between the ages of 35 and 50 and has a habit of drinking a lot of alcohol, possibly alcoholics. Some other causes leading to chronic pancreatitis are metabolic disorders in the body such as protein deficiency, lipid excess for a long time, lead poisoning, mercury poisoning or some other causes related to chronic pancreatitis. self-exempt. Secondary chronic pancreatitis is usually caused by obstruction of the pancreatic duct or the ampulla of Vater.
Some common clinical manifestations of chronic pancreatitis are:
Epigastric pain, pain increasing gradually after meals, pain spreading to the back, pain may be mild and prolonged or severe and persistent; Vomiting, nausea; Weight loss; Digestion of fat; Chronic pancreatitis, if not detected and treated in the first place, will lead to malabsorption with diabetes for about 10 years afterward. Regarding the treatment method, the focus is on medical treatment for the patient, sometimes it is necessary to consider surgery if the patient has abdominal pain for too long and does not respond to medical treatment. The surgical treatment of chronic pancreatitis is either draining the pancreatic duct or connecting the pancreatic duct to the intestine, or it is also possible to apply the technique of removing one or more parts of the pancreas in patients with severe chronic pancreatitis. In addition, it is very important that the patient needs to give up the habit of drinking a lot of alcohol, eating according to the diet that the doctor recommends including high protein, low fat, low starch and divided into many meals a day.

Nôn, buồn nôn là biểu hiện lâm sàng thường gặp của viêm tụy mãn
Nôn, buồn nôn là biểu hiện lâm sàng thường gặp của viêm tụy mãn

2. Computed tomography pancreatitis


Besides clinical symptoms, subclinical plays an important role in diagnosing gastrointestinal diseases, especially chronic pancreatitis. For this pathology, the conventional ultrasound method is less effective in the diagnosis, instead computed tomography pancreatitis is applied more with high efficiency in diagnosis.
More specifically, the image of chronic pancreatitis when computed tomography of pancreatitis can be seen very clearly even without contrast injection, calcifications, stones in the pancreatic duct as well as the Diffuse or localization of inflammatory tissue. Regarding the size of the pancreas, there are certain changes, patients with chronic pancreatitis when computed tomography of pancreatitis may see the size of the pancreas enlarged or smaller than normal, which should be distinguished from other cases of pancreas. of the elderly with atrophy or the case of an enlarged pancreas with solid tumours.
Another feature is that the Wirsung duct is dilated, based on this feature, pancreatitis is divided into 3 types according to Kasugai as mild with normal Wirsung duct with some abnormal anastomosis, may have signs of both Wirsung's duct is irregular and severe, with pancreatic duct stenosis, stones found in the pancreatic duct, pancreatic pseudocyst and common bile duct stenosis. If there is a pancreatic cyst, the computed tomography of pancreatitis will investigate the size and number of cysts, the internal structural features of the cyst. In case the patient has severe pain symptoms due to inflammation of the visceral neuritis, the computed tomography scan will show that the visceral kidney is compressed or there is an uneven infiltrate of the posterior fat organization. pancreas.
When computed tomography of pancreatitis will also detect some common complications of this pathology including:
Pseudocyst, cyst: This is the most common complication, often clinically undetectable. where ultrasonography or contrast-enhanced computed tomography is required, the drug is retained in these cysts, showing unequal density, thickened pancreatic walls, and an irregular, gaseous structure. .. The cyst tends to spread to the mediastinum or to the esophageal orifice, the aortic orifice with the observed image as the border of the diffuse mass is usually regular, thin, with many rings containing fluid and when contrast is injected into the aorta. do not catch. If the cyst is ruptured, it can cause infection, pleural effusion, and peritoneal fluid, and the cyst is not visible on computed tomography of pancreatitis in this case. Biliary dilatation: Caused by compression of the common bile duct or by fibrosis of the pancreas and stones in the pancreas. Portal hypertension or pseudoaneurysm due to pancreatic cyst. Malignant pathology: It is often difficult to detect in the early stages, if the later stage can see changes in the organizational margin, calcification, decrease in density... Gastrointestinal diseases such as splenic rupture, splenic stenosis duodenal ulcer, gastric varices, duodenal ulcer... Pleural effusion. Abdominal effusion.

Hình ảnh chụp cắt lớp vi tính viêm tụy
Hình ảnh chụp cắt lớp vi tính viêm tụy

3. Conclusion


Imaging techniques play an important role in the detection of chronic pancreatitis such as ultrasound and computed tomography of pancreatitis. While ultrasound is not very effective in this area, computed tomography of pancreatitis plays a role in strengthening the diagnosis, helping doctors confirm the diagnosis and provide the most appropriate treatment for the disease. core.
Currently, Vinmec International General Hospital is equipped with a 640-slice CT scanner TSX - 301C manufactured by Toshiba capable of supporting diagnosis on an area up to 16 cm wide, fast speed allows one rotation of the image. The whole heart can be detected, helping to optimally diagnose coronary, vascular and systemic arteries. In particular, this machine can reduce up to 90% of radiation dose, so it can be taken for pregnant women when indicated. The team of technicians are all highly qualified, experienced, and highly trained in diagnostic imaging to help make the most accurate diagnoses.
If you have a need for a CT scan of chronic pancreatitis, please book an appointment directly at the website or contact the hotline for detailed advice.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.

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