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(A) Ultrasonography of the abdomen. Intra-abdominal pancreatic cyst (7 × 8 cm) with echogenic debris. (B) Axial; (C) Sagittal images: contrast-enhanced computed tomography. Complicated pseudocyst, compression of the common bile duct, and dilated biliary tracts.

Fulminant Emphysematous Pancreatic Pseudocyst: Infected with Normal Skin Flora

A 49-year-old man was alcoholic and had major depressive disorder. He experienced epigastric pain, poor appetite, and weight loss for 1 month. Ultrasonography of the abdomen revealed a pancreatic cyst (7 × 8 cm) with echogenic debris (Figure 1A). Contrast-enhanced computed tomography (CT) of the abdomen showed a complicated pancreatic pseudocyst (Figure 1B), compressed common bile duct, […]

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Contrast-enhanced computed tomography of the abdomen in coronal view showing peripancreatic inflammatory changes consistent with acute pancreatitis.

Hypertriglyceridemia-Induced Acute Pancreatitis with Normal Pancreatic Enzymes

To the Editor: The diagnosis of acute pancreatitis requires 2 of the following 3 features: 1) abdominal pain consistent with acute pancreatitis; 2) serum lipase activity (or amylase activity) at least 3 times greater than the upper limit of normal; and 3) characteristic imaging findings of acute pancreatitis.1 Although normal serum amylase levels have been reported […]

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Contrast-enhanced axial slice abdominal computed tomography showing extensive peripancreatic phlegmon with abundant gas (arrows) replacing the necrotizing nonenhancing pancreatic tail. Note the normal enhancement of the pancreatic parenchyma medial to the tail.

Emphysematous Pancreatitis

A 63-year-old woman with a history of severe alcohol abuse presented with persistent abdominal pain radiating to the back, vomiting, and lassitude over a week. Examination showed tachycardia, abdominal tenderness, and bipedal edema. Abdominal ultrasound demonstrated only fatty liver. Laboratory tests were notable for white blood cell count of 16.1 × 109/L, serum albumin 1.8 g/dL, and increased […]

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Diffuse Cerebral Edema from Acute Pancreatitis Induced by Hypertriglyceridemia

Hypertriglyceridemia is the third most common cause of acute pancreatitis, accounting for up to 4% of cases.1, 2Severe acute pancreatitis is characterized by persistent organ failure for >48 hours and warrants intensive care unit admission because it has a mortality rate of 20%.3 Patients with severe acute pancreatitis have been noted to have higher levels of proinflammatory […]

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