[Diagnostic value of abdominal plain films in acute pancreatitis (author's transl)]

Duodenal distension is in connection with corresponding clinical symptoms--the pathognomonic symptom of acute pancreatitis, provided that the film is taken in left lateral decubitus position. In 90% of 192 cases of acute pancreatitis, proven by surgery or high amylase concentration, duodenal distension was diagnosed on the film taken in left lateral decubitus position. If there is the temptative diagnosis of acute pancreatitis and no duodenal distension is demonstrable, this may result from a fluidfilled stomach without air after vomiting or a stomach tube, through which the air may escape. In these cases we give an effervescent powder to demonstrate duodenal distension. The combination of duodenal atony and distension of the small or large bowel is found very often as a sign of spread pancreatic enzymes along definite anatomic planes in the abdomen like transverse mesocolon and small bowel mesentery. The abdominal plain film taken in supine and left lateral decubitus position gives many important informations solving differential diagnostic problems concerning processes in the upper abdomen and determines further diagnostic and therapeutic proceedings considerably.