[Ultrasonic morphology of acute pancreatitis taking into consideration the degree of severity]

The ultrasonic findings of 37 patients with acute pancreatitis were related to the severity of the disease according to the Ranson criteria (RK). Pathologic findings of the pancreas were found in every case of severe pancreatitis (oedema, necrosis, conglomerate tumour), whereas in the large group of mild pancreatitis (0-2 RK, n = 26) only 17 patients showed an oedematous swelling of the organ. In 5 patients with mild pancreatitis a tryptic exudation was observed in the peripancreatic area, which must be considered as necrosis in 4 cases because of its long-lasting persistence in follow-up. Five patients in this group showed a rapid reversible ascites representing an effusion due to peritoneal irritation. In the group of severe pancreatitis, peripancreatic exudations were seen in 10 of 11 patients; the higher the severity of disease, the higher was the incidence of ascites, pleural effusions and sonographic signs of ileus.