胰腺分的离影像学诊断.pdf

Hilary Hochberg Gillian Lieberman, MD September 2001 Pancreas Divisum: Patient Presentation and Discussion Hilary Hochberg Advanced Radiology Clerkship Beth Israel Deaconess Medical Center Dr. Gillian Lieberman Hilary Hochberg Gillian Lieberman, MD Patient JC •44 yo male •Abdominal pain, epigastric, radiating to back x 1d •Nausea, vomiting, diaphoresis, low-grade fevers, chills •PMHx: 4 m ago, EU abdominal pain Normal CT 2 Hilary Hochberg Gillian Lieberman, MD Physical Exam Vitals: T 100.3 P70 RR20 BP 150/90 • Abd: Distended, tenderness to palpation diffusely, mostly periumbilical • -Rebound +Voluntary guarding • BS markedly depressed • No Cullen/Grey Turner sign 3 Hilary Hochberg Gillian Lieberman, MD Labs CBC: WBC 13.4 Hct 42 Plets 257 Amylase 2302 Lipase 1940 LFTs: ALT/AST 47/23 LDH 199 Alk Phos 83 TG 264 E’lytes: 143 | 104 | 23 / 150 Ca 9.3 / Ph 4.1/ Mg 2.0 4.3 | 25 | 0.9 \ 4 Hilary Hochberg Gillian Lieberman, MD Our Patient JC: Abdomenal CT Indistinctive Fat stranding pancreatic (misty appearance)