Uneven contours of the pancreas on ultrasound: what is it?

Often, after undergoing ultrasound diagnostics of the abdominal organs, patients hear in conclusion that the contours of the pancreas are fuzzy uneven and echogenicity is increased.

Not always this conclusion indicates a gross pathology. In some cases, this sign is transient and after some time passes.

But it is impossible to ignore such a state.

Any suspicious condition requires detailed study and diagnosis, including the conclusion that the pancreatic contours are uneven and fuzzy.

Ultrasound diagnosis is the most popular, completely non-invasive method of research and diagnosis of many organs, and even systems.

This opportunity is due to the phenomenon of echogenicity. It represents the ability of organs to reflect ultrasound directed from the sensor.

Any organ is characterized by a certain density and structure. The structure of the body may be homogeneous and heterogeneous. Evenly echogenic is a homogeneous structure element.

Hyperechogenicity can mean an increase in the density of the organ under study. If the irregular contour of the pancreatic edge arises on ultrasound, it often confirms the fibrous changes of the organ.

When does a similar organ change occur?

Normally, the pancreas and the parenchyma of the organ itself are clearly visualized on ultrasound.

But under some circumstances and diseases, a wavy area, a scalloped angle and other changes in echogenicity can be visualized.

Changes may be local or diffuse.

This is an important diagnostic criteria for setting the prevalence of the process.

Diffuse process occurs when the following pathologies:

  1. Puffiness or anasarca. Swelling of the internal organs occurs when they are directly affected or if they are secondary to the lesion in the case of pathology of another organ. Primary edema occurs in the case of pancreatitis. In this case, the swelling is an indication for the immediate start of treatment. Anasarka is a swelling of all organs and tissues of the body, including the pancreas. This condition develops due to severe damage to the cardiovascular system or kidney filter.
  2. Autolysis or necrosis of pancreatic tissue. This is an extremely severe surgical pathology, which is a consequence of acute pancreatitis. In this case, all functional active cells of the organ die, and the pancreas does not clearly differentiate. Autolysis is accompanied by the release into the bloodstream of a large number of enzymes. In the analysis of blood, the doctor notes how the enzymatic activity of the blood rises.
  3. Fatty degeneration of pancreatic tissue. When this happens, the active cells are replaced with inactive adipose tissue. The process is chronic and is not accompanied by severe symptoms.
  4. Diabetes mellitus type 1, despite its hormonal nature, has a pathological focus. In the first type of disease, the death of the islet of Langerhans diffusely throughout the organ and this is noticeable in the ultrasound study.
  5. Tumor organ or metastatic lesion. To exclude cancer, a number of other studies should be carried out, such as MRI, CT, and biopsy.
  6. Polycystic lesion or multiple organ cysts. Such pathological foci have a clear appearance and a smooth edge, phenomena characteristic of a disease such as cystic fibrosis.

Additionally, the occurrence of a diffuse process is observed in organ fibrosis. This disease is characterized not only by high echogenicity, but also by a decrease in the organ itself.

What is local hyperechogenicity?

Local hyperechogenicity is a section of the pancreas, having a high acoustic density.

This phenomenon occurs in several cases.

The most characteristic is the appearance of local hyperechogenicity in the formation of a single cyst, as a manifestation of inflammation of the gland in history.

In addition, this result of the study is obtained in the identification of the body:

  • calcification, petrification site, which is caused by chronization of the pathology;
  • the area of ‚Äč‚Äčaccumulation of adipose tissue;
  • fibrous node formed due to the healing of necrotic tissue;
  • pancreolithiasis, or stone formation in the organ;
  • pancreatic cancer, has a bumpy surface;
  • secondary metastasis in oncology, more often are blurred during imaging;
  • abscess in the infectious purulent process of another organ, often occurs when staphylococcal sepsis.

The latter state is very dangerous for the body.

It is worth remembering that the conclusion of an ultrasound specialist is not a diagnosis and require further consultation of the doctor. Such anomalies include changes in shape, additional area, doubling of the body. The most important parameter is the preservation of the exocrine and endocrine activity of the organ.

Among other things, there are congenital anomalies of the body that do not carry a danger to the life of the patient.

Preparing for an ultrasound scan and what a healthy pancreas looks like

To investigate and evaluate diffuse changes in the pancreas, reviews are collected according to all international recommendations. The correct conclusion is the immediate task of the sonologist and the appointment of the treatment of the treating doctor.

But improper preparation of the patient can lead to an incorrect diagnostic decision and incorrect treatment.

First of all, the patient should follow a number of the following recommendations:

  1. 12 hours before the procedure is not recommended to eat.
  2. On the eve of the study should empty the bowels.
  3. Ultrasound is performed on an empty stomach and in the morning.
  4. A few days before the procedure, the patient excludes from the diet all products that contribute to excessive gas formation.
  5. If the patient has flatulence, then sorbents should be taken.

With ultrasound screening, the organ is fully accessible by inspection. All its parts are visually accessible.

The form of the body resembles the letter of the English alphabet "S".

A healthy gland has normal dimensions, even regular walls. The contour is correct without any abnormalities.

The structure of the organ in most cases is homogeneous, but some hyperechoic blotches may be present.

Also investigate the adjacent organs, including the liver, intestinal areas, kidneys.

Often changes in these organs can affect the structural state of the pancreas.

It is worth remembering that even in the presence of suspicious signs on the ultrasound should not panic. An accurate diagnosis often requires a range of laboratory and instrumental samples, ranging from simple blood tests to trepan biopsy of gland tissue.

After the procedure, the sonologist during a short period of time deciphers the sensor and gives the wording to the patient's hands.

The signs of pancreatic diseases are discussed in the video in this article.

Watch the video: "Bowel and Mesenteric Injury High Risk Mechanisms and CT Findings" by George Taylor for OPENPediatr (April 2020).