Pankreatiti akut (Pjesa e dytë)
Fig 4: Ekzaminim skanerik ku paraqitet nje pseudokist ne trupin dhe bishtin e pankreasit.
Fig 3: Ekzaminim ekografik ku paraqitet pseudokist i kokes se pankreasit
Te dhenat ne CT te pankreatitit akut
- Zmadhim difuz i pankreasit
- Konturet e tij jane te deformuara
- Fascie Gerota trashet dhe shtohet densiteti i indit adipoz peripankreatik
- Trashje fokale e mureve te stomakut, kjo shenje takohet ne 70% te rasteve me pankreatit akut.
Komplikacionet e pankreatitit akut
- Pseudokist i pankreasit: koleksion fluid pankreatik oval ose i rrumbullkaket, i kapsuluar, i mbeshtjelle nga nje kapsule e dallueshme fibroze: kerkon te pakten 4 jave qe te formohet: dimensionet e mureve te pseudokisteve caktohen me sakte me ane te CT.
- Pankreatit hemoragjik: si rezultat i erozionit te vazave dhe nekrozes indore. Ne CT kemi gjak (me densitet te larte) ne retroperitoneum.
- Abceset: kolleksion i kufizuar i pusit me ose pa nekroze indore. Duket si nje koleksion fluid me capsule te trashe. Zhvillohen ne 4 % te rasteve me pankreatit akut. Shenje karakteristike ne CT eshte prania e gazit ne pancreas apo peripankreatik. Gazi formohet nga bakteret gazformuese. Nese gazi nuk eshte present atehere nuk eshte e lehte te dallosh pseudokistin nga abcesi. Ne keto raste diagnoza perfundimtare vihet nepermjet aspirimit te permbajtjes me nje age te holle.
- Pseudoaneurizem: autodigjestion i murit arterial nga enzimat pankreatike, qe rezulton ne nje mase pulsative, e rrethuar nga ind fibroz dhe ruan komunikimin me arterien e origjines.
- Nekroze likuide e parenkimes pankreatike qe ne CT me contrast IV bolus kemi mungese te perforcimit parenkimal, ndonjehere dhe multifocale.
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