60-year-old man presented to the OPD with symptoms suggestive of acute pancreatitis. He consumes high quantities of alcohol regularly. His symptoms started 4 days ago. But he continued to consume alcohol. He was admitted for further evaluation.
Presently, he has severe vomiting. He also
complains of dizziness when standing.
Examination revealed tenderness in the
epigastrium and right hypochondrium. A
reddish discolouration is noted in the
flanks. Which of the following statements
regarding the patient is most accurate?
• The history and clinical features (Abdominal
tenderness, hypotension due to blood loss, Grey Turner’s sign) are suggestive of acute pancreatitis with pancreatic necrosis.
• Hence a contrast CT scan of the abdomen will reveal severe necrotising pancreatitis.
• CLINICAL SIGNS IN ACUTE PANCREATITIS
-Reddish / bluish discolouration of the flanks is known as Grey Turner’s sign.
- It is seen in cases of acute pancreatitis with pancreatic necrosis and intra-abdominal bleeding.
-Another feature of pancreatic necrosis is a bluish discolouration around the umbilicus, known as Cullen’s sign.
-Both these signs take 1-2 days to develop in a case of acute pancreatitis. CT FINDINGS IN ACUTE
PANCREATITIS
-Focal / diffuse enlargement of pancreatic
parenchyma
-Indistinct margins
-Density changes due to presence of oedema
-Retroperitoneal stranding
Elimination of the other options
- Pseudocyst of pancreas usually develops a few weeks after the onset of pancreatitis
-The features are not suggestive of appendicitis
-Pancreatic calcification is seen in chronic
pancreatitis