case_images: PMC3079872_01
case_images: (a) Ultrasound abdomen demonstrates hyperreflective pancreas, indistinguishable from normal retroperitoneal fat; (b and c) contrastenhanced axial CT images demonstrate atrophic pancreas with total fat replacement. The entire pancreas has low attenuation value (HU = -120). Main pancreatic duct appears to be stenotic (rather than dilated), suggesting chronic severe obstruction; (d) noncontrast axial CT image shows solitary calculus in distal pancreatic duct near the ampulla of Vater; and (e) contrastenhanced axial CT image demonstrates mildly dilated small bowel loops with wall thickening and dilution of contrast medium
case_images: IJEM-15-51-g001.jpg
case_images: PMC3079872_01_IJEM-15-51-g001.jpg
case_images: F1
case_images: Ultrasound abdomen revealed hyperreflective pancreas [Figure 1a], free fluid within the pelvic cavity, and mildly dilated small bowel loops with thickened wall. Computed tomography revealed atrophic pancreas with complete fatty infiltration (attenuation value = -120 HU), and no demonstrable normal pancreatic parenchyma [Figure 1b and c]. Solitary calculus was noted within the pancreatic duct near the ampulla of Vater without pancreatic duct dilatation [Figure 1d]. Small bowel wall thickening with increased intraluminal fluid and dilution of contrast medium was also evident [Figure 1e].