Image Based Question – 74522

A 76 y ears old male presents to the emergency with abdominal pain and an episode of binge drinking in shock with a BP of 70/50 mm Hg and HR of 115/ min. The oxygen saturation of the patient is 70 mm Hg. Serum creatinine level was 2.4 mg/dl. The patient had raised transaminases. What is the likely diagnosis based on the CT image shown below?

A. Liver abscess

B. Acute pancreatitis

C. Acute pyelonephritis

D. Severe acute pancreatitis

Correct Answer » D Explanation

Ans: D. Severe acute pancreatitis

(Ref: Sabiston 20/e p1528, 19/e p1519-1526; Bailey 27/e p1223-1224, 26/e p1127-1129; Shackelford 7/e p1123-1130)

• The given CT image showing extensive pancreatic necrosis in combination with the acute clinical presentation is typical of severe acute pancreatitis.