Evaluation of unusual causes of pancreatitis: Role of cross-sectional imaging

• Published in: European journal of radiology Vol. 71; no. 2; pp. 296 - 312
• Main Authors: Kwak, Sang Wook, Kim, Suk, Lee, Jun Woo, Lee, Nam Kyung, Kim, Chang Won, Yi, Mi Seon, Kim, Gwang Ha, Kang, Dae Hwan
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.08.2009; Elsevier
• Subjects: Biological and medical sciences; Computed tomography; Diagnosis, Differential; Digestive system. Abdomen; Endoscopic ultrasonography; Endoscopy; Etiology; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Investigative techniques, diagnostic techniques (general aspects); Liver. Biliary tract. Portal circulation. Exocrine pancreas; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Medical sciences; Other diseases. Semiology; Pancreatitis; Pancreatitis - diagnosis; Pancreatitis - etiology; Radiology; Rare Diseases - complications; Rare Diseases - diagnosis; Tomography, X-Ray Computed - methods; Computed tomography; Magnetic resonance imaging; Etiology; Endoscopic ultrasonography; Pancreatitis; Nuclear medicine; Radiodiagnosis; Nuclear magnetic resonance imaging; Cross-sectional imaging; Radiology; Medical imagery; Digestive diseases; Computerized axial tomography; Pancreatic disease
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2008.04.006

Abstract There are widely diverse causes of pancreatitis. Gallstone and alcohol have been recognized as the most common causes of pancreatitis accounting for 90% of cases. However, acute and chronic pancreatitis may also result from a variety of uncommon causes. The determination of the etiology is important for patient management and prevention of recurrence. Sludge is the most common cause of idiopathic or recurrent acute pancreatitis. Endoscopic ultrasonography is considered as the most accurate diagnostic test for this abnormality. Computed tomography (CT) and magnetic resonance imaging (MRI) have only a limited role in the diagnosis of sludge. However, papillitis observed on the contrast-enhanced CT and MR may provide clues to the detection of pancreatitis secondary to sludge, a small stone or a recently passed stone. Radiological studies, clinical presentation and laboratory data can be helpful in determining the etiology of unusual causes of pancreatitis such as anatomic anomalies, autoimmune pancreatitis, groove pancreatitis, and traumatic pancreatitis.