Further imaging

Imaging investigations tend to be less helpful in making a diagnosis in patients with pancreatitis than in other causes of abdominal pain.

Abdominal x-rays

A plain abdominal x-ray offers little in making the diagnosis of acute pancreatitis, although may show an ileus or some calcification of the pancreas in chronic pancreatitis.

Click on the unremarkable plain abdominal x-ray to enlarge.



Ultrasound scans tend to be unhelpful since the pancreas is only visualised in 20-25% of those with acute pancreatitis; where it is helpful is in demonstrating gallstones or common bile duct dilatation and the possible need for an endoscopic retrograde cholangiopancreatography (ERCP).

Click on the ultrasound of a normal pancreas to enlarge.



CT is useful, although may be normal in the early stages of pancreatic inflammation. There is some debate about timing of CT in patients with pancreatitis and it seems best performed early in patients in whom the diagnosis is in doubt or severe disease is suspected [5]. It is not current practice in the UK to perform early CT. However, CT is of more value in the ongoing management of pancreatitis by identifying complications such as a pseudocyst.

Click on the normal abdominal CT scan to enlarge.


Learning Bite

X-rays offer little in the diagnosis of acute pancreatitis; USS and CT have limited roles in the assessment of the patient with pancreatitis.

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