Ultrasonography in acute pancreatitis

Ultrasound examination of the pancreas in an emergency situation is often neither easy to perform or interpret, nor is it particularly sensitive or specific. This leads to a high frequency of indeterminate results in a critically ill patient even in expert hands. While there are technical difficulties in the first 24 to 48 hours owing to paralytic ileus and abdominal guarding, it is a good practice to keep in mind the following goals of ultrasonography in the initial period. a) To suggest an alternative diagnosis (eg. hepatic abscess, acute cholecystitis, etc.) if any. b) Evaluate gall bladder and biliary tree clarify etiology of biliary pancreatitis. c) Clarify diagnostic dilemmas in questionable cases of mild pancreatitis. d) To diagnose pancreatic and peripancreatic fluid collections or phlegmon. e) Follow up phlegmon for development of pseudocyst. f) To suggest hemorrhagic fluid collections. g) Detection and diagnosis of pseudoaneurysms.