Pancreatitis Aguda focal
Masculino 07 años de edad que se presenta por dolor intenso en área epigástrica con irradiación hacia la espalda.El dolor apareció tras un golpe en región epigástrica por caída de una bicicleta. El examen sonografico demuestra un incremento de la ecogenicidad de las paredes de las ramificaciones portales del hígado ( hígado estrellado ) y un aumento del grosor de la cola pancreática, sin presencia de lesiones focales en el mismo. La analítica coincide con el diagnóstico clínico-sonografico de Pancreatitis aguda, en este caso focalizada solo en cola pancreática, la cual mide aprox: 2.23 cm en sentido AP . El eco-Doppler y la Elastografia no muestran signos patológicos per se y no hay presencia de lesiones focales, pseudo-quistes o presencia de liquido peri-pancreático.
El hígado luce aumentado de tamaño con un lóbulo derecho de aprox: 11.37 cm en sentido AP ( normal hasta 10.0 cm para su rango de edad) , muestra aumento de la ecogenicidad a expensas de su incremento en las paredes de las ramificaciones portales, compatible con el diagnóstico de hígado estrellado.El bazo luce aumentado de tamaño,mide aprox: 8.43 X 3.85 X 9.93 cm, volumen aprox: 168.75 ml. Se concluye con los diagnósticos de Hepato-esplenomegalia, hígado estrellado y pancreatitis focal.
* El hígado estrellado es un cuadro sonografico en el cual las paredes de las ramificaciones venosas hepáticas ( ramificaciones portales ) se hacen visibles por el aumento de su ecogenicidad, esto suele estar relacionado con la ingesta de múltiples medicamentos, fundamentalmente analgesicos tipo Acetaminofen, Ibuprofeno,ácido mefenámico, etc.
Male, 07 years of age, present with severe pain in the epigastric area with irradiation to the back. The pain appeared after a blow in the epigastric region due to the fall of a bicycle. The sonographic examination shows an increase in the echogenicity of the walls of the portal branches of the liver (starry sky liver) and an increase in the thickness of the pancreatic tail, without the presence of focal lesions in the same. The analysis coincides with the clinical-sonographic diagnosis of acute pancreatitis, in this case, focused only on the pancreatic tail, which measures approx: 2.23 cm in the AP direction. The Doppler and Elastography show no pathological signs per se and there is no presence of focal lesions, pseudo-cysts, or presence of peri-pancreatic fluid.
The liver appears enlarged with a right lobe of approximately 11.37 cm in the AP direction (normal up to 10.0 cm for its age range), shows an increase in echogenicity due to its increase in the walls of the portal branches, compatible with the diagnosis of starry sky liver. The spleen looks bigger, measures approx: 8.43 X 3.85 X 9.93 cm, volume approx: 168.75 ml. It concludes with the diagnosis of hepato-splenomegaly, starry sky liver, and focal pancreatitis.
* Starry sky liver is a sonographic picture in which the walls of the hepatic venous ramifications ( portal branches ) are made visible by the increase in their echogenicity, this is usually related to the intake of multiple medications, mainly analgesics type Acetaminophen, Ibuprofen, mefenamic acid, etc.
El hígado luce aumentado de tamaño con un lóbulo derecho de aprox: 11.37 cm en sentido AP ( normal hasta 10.0 cm para su rango de edad) , muestra aumento de la ecogenicidad a expensas de su incremento en las paredes de las ramificaciones portales, compatible con el diagnóstico de hígado estrellado.El bazo luce aumentado de tamaño,mide aprox: 8.43 X 3.85 X 9.93 cm, volumen aprox: 168.75 ml. Se concluye con los diagnósticos de Hepato-esplenomegalia, hígado estrellado y pancreatitis focal.
* El hígado estrellado es un cuadro sonografico en el cual las paredes de las ramificaciones venosas hepáticas ( ramificaciones portales ) se hacen visibles por el aumento de su ecogenicidad, esto suele estar relacionado con la ingesta de múltiples medicamentos, fundamentalmente analgesicos tipo Acetaminofen, Ibuprofeno,ácido mefenámico, etc.
Acute Traumatic Focal Pancreatitis
Male, 07 years of age, present with severe pain in the epigastric area with irradiation to the back. The pain appeared after a blow in the epigastric region due to the fall of a bicycle. The sonographic examination shows an increase in the echogenicity of the walls of the portal branches of the liver (starry sky liver) and an increase in the thickness of the pancreatic tail, without the presence of focal lesions in the same. The analysis coincides with the clinical-sonographic diagnosis of acute pancreatitis, in this case, focused only on the pancreatic tail, which measures approx: 2.23 cm in the AP direction. The Doppler and Elastography show no pathological signs per se and there is no presence of focal lesions, pseudo-cysts, or presence of peri-pancreatic fluid.
The liver appears enlarged with a right lobe of approximately 11.37 cm in the AP direction (normal up to 10.0 cm for its age range), shows an increase in echogenicity due to its increase in the walls of the portal branches, compatible with the diagnosis of starry sky liver. The spleen looks bigger, measures approx: 8.43 X 3.85 X 9.93 cm, volume approx: 168.75 ml. It concludes with the diagnosis of hepato-splenomegaly, starry sky liver, and focal pancreatitis.
* Starry sky liver is a sonographic picture in which the walls of the hepatic venous ramifications ( portal branches ) are made visible by the increase in their echogenicity, this is usually related to the intake of multiple medications, mainly analgesics type Acetaminophen, Ibuprofen, mefenamic acid, etc.
