IMAGING OF PANCREATIC TRANSPLANTATION USING PORTAL VENOUS AND ENTERICEXOCRINE DRAINAGE

OBJECTIVE, We describe the normal radiologic appearance of pancreatic allografts transplanted using portal venous drainage with enteric drai nage of exocrine secretions. We also describe the radiologic appearanc e of postsurgical complications. MATERIALS AND METHODS. Of 56 patients who received pancreatic transplants using the portal-enteric techniqu e, 24 patients subsequently required radiologic examination for suspec ted complications involving the pancreatic allograft. Twenty-three pat ients underwent CT scanning; a total of 58 CT scans were obtained. Nin e abdominal sonograms were obtained in five patients, and one patient underwent angiography. The radiologic appearance of each transplant an d the complications were analyzed retrospectively and correlated with the clinical course. RESULTS. The most common indications for CT scann ing were fever, elevated levels of serum amylase, and evaluation or fo llow-up of fluid collections. CT showed the normal and abnormal anatom y of the allograft. Abnormal findings seen in the 58 CT scans included fat stranding (30 scans), ascites (21 scans), peripancreatic fluid or pseudocyst (13 scans), and heterogeneity of the allograft (five scans ). One patient had pancreatic infarction with pneumatosis and pneumope ritoneum. The allograft was obscured by bowel gas on three sonograms. Four sonograms showed no abnormalities tone Doppler sonogram showed th e arterial supply and venous drainage), and one sonogram showed a pseu docyst. In the one patient who underwent angiography, imaging showed n o arterial blood flow to the transplant. CONCLUSION. Pancreatic transp lantation with portal venous drainage and enteric drainage of exocrine secretions and the complications of such transplantation were reveale d with CT, sonography, and angiography. Knowledge of normal anatomic c onfiguration will allow proper interpretation of normal and abnormal f indings.