New sonographic imaging observations in focal pancreatitis

The imaging findings that ultrasonographically differentiate focal acute pa ncreatitis (FAP) from a malignant lesion of the pancreas are described. Foc al acute pancreatitis is ultrasonographically (US) characterized as a hypoe choic, homogeneous, localized, subsegmental, non-expansive and diffusely de marcated lesion located mostly in the head of the pancreas. It could not be visualized using CT Endoscopic retrograde cholangiopancreatography (ERCP) performed in 13 of the 32 patients, showed chronic pancreatitis. Focal acut e pancreatitis disappeared in 1-6 months at US follow-up. The clinical diag noses were acute pancreatitis in 11 patients, chronic pancreatitis in 12 pa tients, biliary disease in 5 patients, hepatopathia in 1 patient while the diagnosis was known in 2 patients. No patient developed any pancreatic canc er during a median of 85 months of follow-up. In conclusion, the present da ta indicate that patients with FAP at US, without any focal lesion seen on either CT or ERCP, have a benign pancreatic lesion, which resolves in 1-6 m onths; thus, such patients probably do not need any further investigation o r follow-up at all.