In the "proton pump inhibitors era",a penetrating peptic ulcer(PPU) represents an exceptional cause of abdominal pain,and was more frequently observed in the past where there was not an effective antacid tre...In the "proton pump inhibitors era",a penetrating peptic ulcer(PPU) represents an exceptional cause of abdominal pain,and was more frequently observed in the past where there was not an effective antacid treatment. Ulcer-induced pancreatitis is very rare,too,and manifests with persistent,intense pain radiating to the back. A mild to severe pancreatitis with peripancreatic fluid collection can be observed at imaging. However,only a few cases of association between PPU and emphysematous pancreatitis(EP) have been published in the literature. EP is a rare but potentially fatal form of acute necrotizing pancreatitis in which gas grows in and outside the pancreas,and typically involves the whole parenchyma in diabetic individuals.Here we report an extremely rare case of a duodenal ulcer penetrating the pancreas and complicated with EP.Unlike the classic form of EP,which involves the whole parenchyma and has a poor prognosis,we found that the emphysematous involvement of the pancreas by PPU has a benign course if a conservative therapy is promptly established. Gas is confined to the site of penetration,usual y the pancreatic head,and ulcers most often involve the duodenum.展开更多
Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for...Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound(US)is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs(e.g.,lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.展开更多
文摘In the "proton pump inhibitors era",a penetrating peptic ulcer(PPU) represents an exceptional cause of abdominal pain,and was more frequently observed in the past where there was not an effective antacid treatment. Ulcer-induced pancreatitis is very rare,too,and manifests with persistent,intense pain radiating to the back. A mild to severe pancreatitis with peripancreatic fluid collection can be observed at imaging. However,only a few cases of association between PPU and emphysematous pancreatitis(EP) have been published in the literature. EP is a rare but potentially fatal form of acute necrotizing pancreatitis in which gas grows in and outside the pancreas,and typically involves the whole parenchyma in diabetic individuals.Here we report an extremely rare case of a duodenal ulcer penetrating the pancreas and complicated with EP.Unlike the classic form of EP,which involves the whole parenchyma and has a poor prognosis,we found that the emphysematous involvement of the pancreas by PPU has a benign course if a conservative therapy is promptly established. Gas is confined to the site of penetration,usual y the pancreatic head,and ulcers most often involve the duodenum.
文摘Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound(US)is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs(e.g.,lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.
