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PANCREAS -Transverse Scan, Longitudinal Scan | NORMAL Pancreas | Indication, Recognize Image

PANCREAS -Transverse Scan


Indication

  • Midline upper abdominal pain, acute or chronic.
  • Jaundice.
  • Upper abdominal mass.
  • Persistent fever, especially with upper abdominal tenderness.
  • Suspected malignant disease.
  • Recurrent chronic pancreatitis.
  • direct abdominal trauma, particularly in children.

  • Preparation

  1. Preparation of the patient:The patient should take nothing by mouth for 8hrs preceding the examination.
  2. Position of the parient: Start with the patient lying supine: the patient may latter need to be turn on the left side or examined erect or on hands and knees.
  3. Choice of transducer: 3.5MHz for adult, 5MHz for children thin adult.
  4. Setting the correct gain: Start by placing the transducer centrally at the top of the abdomen.
Transverse scanning
Start with transverse scans across the abdomen moving downwards towards the feet until the splenic vein is seen as a linear, tublar structure withe the midial end broadended . This is where it is joined by the superior mesenteric artery will bw seen in cross-section just below the vein.

Continue transverse scans downwards to visualize the head of the pancreas and the uncinate between the inferior vena cava and the portal vein.

PANCREAS -Transverse Scan, Longitudinal Scan | NORMAL Pancreas | Indication, Recognize Image
portal vein, inferior vena cava

Longitudinal scan

         Start longitudinal scanning just to the right of the midline and identify the tublar pattern of the inferior vena cava should not be compressed or flattened by a normal pancreas.

Continue longitudinal scans moving to the left. Identify the aorta and the superior mesenteric artery. This will assist in identifying the body of the pancreas.

                                                            longitudinal scan of pancreas

Normal pancreas 

The pancreas has about the same echogenicity as the adjacent liver and should appear homogeneous. However, the pancreatic echogenicity increase with age. The outline of the normal pancreas is smooth.

When scanning the pancreas, certain anatomical landmarks should be identified, in the following order:
  1. Aorta
  2. Inferior vena cava 
  3. Superior mesenteric artery
  4. splenic vein
  5. superior mesenteric vein
  6. Wall of the stomach 
  7. Common bile duct
The essential landmark are the superior mesenteric artery and the splenic vein.

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