Читать книгу Clinical Pancreatology for Practising Gastroenterologists and Surgeons - Группа авторов - Страница 81

CT can assess for common bile duct (CBD) stones, which account for 40–70% of AP, although abdominal ultrasound and magnetic resonance cholangiopancreatography are the preferred methods of detection [5]. CT can evaluate for obstructive causes of AP including mass, cystic neoplasms, or pancreatolithiasis from chronic pancreatitis. Approximately 5–14% of patients with benign or malignant pancreatic masses may present with AP [4,10–12]. A pancreatic tumor may be seen as a focal area of high or low attenuation compared to the surrounding parenchyma. Other findings suggestive of a pancreatic neoplasm seen on CT imaging include an strictured or dilated pancreatic duct, deformed pancreatic contour, mass effect, arterial encasement, venous obstruction, dilated bile duct, metastasis, glandular atrophy of the distal parenchyma, and/or lymphadenopathy [13]. Other etiologies of AP that may be detected on CT include an intraluminal duodenal diverticulum. This should be suspected when CT reveals an enlarged duodenum, and a fluid density with a thin rim surrounded by hypodense tissue [14,15].