Pancreas

Question 1

Normal pancreatic anatomy:

Answer 1

Question 2

What structures are in close proximity to the pancreas?

Answer 2

• stomach
• duodenum
• cecum
• ascending colon
• transverse colon

Question 3

Differential diagnoses for pancreatic disease:

Answer 3

pancreatic disease not commonly visible on radiographs, especially insufficiency and DM

Question 4

What 2 abnormal Roentgen signs are associated with pancreatitis?

Answer 4

1. increased soft tissue opacity at the pyloroduodenal angle typically due to focal effusion or pancreatic enlargement (also widens angle)
2. caudal displacement of transverse colon with enlargement of the body and/or left limb

(most often, radiographs are normal)

Question 5

Pancreatitis:

Answer 5

• increased soft tissue opacity
• widening of pyloroduodenal angle
• caudally displaced transverse colon due to mass effect

Question 6

What Roentgen finding is associated with pancreatic masses?

Answer 6

increased soft tissue opacity and mass effect - difficult to differentiate from pancreatitis

Question 7

What are the 4 most common etiologies of pancreatic masses?

Answer 7

1. abscess
2. pseudocyst
3. exocrine neoplasia
4. endocrine neoplasia (insulinoma), typically not visible

Question 8

How does the feline pancreas differ?

Answer 8

can occasionally observe the distal portion of the left limb within the peritoneal fat bordered by the stomach cranially, spleen laterally, and left kidney caudally

• consider inflammation if it seems thickened, irregular, increased opacity, or if there is localized effusion

Question 9

In what 3 ways does pancreatitis affect other organs on radiographs?

Answer 9

1. focal loss of serosal margin detail secondary to focal effusion or steatitis
2. right cranial abdominal mass effect due to pancreatic enlargement - widened pyloroduodenal angle, medially displaced cecum/ascending colon, caudal displacement of transverse colon
3. descending duodenal abnormalities due to inflammation from the right limb - mild gas-filling effect, undulating effect of corrugation