Man 50 yo, one week ago, onset periumbilical pain and abdominal distension, no defecation nor fever.
Chest Xray, and abdomen standing plain film showed the water-air level in intestine, suggesting bowel obstruction.
Ultrasound found out colon dilatation, filling water and moving circular around with hyperperistalsis (see video).
MSCT of abdomen in emergency detected dilated right colon and small intestine, retroperitoneum edema arround the pancreas and radiologist suggested that pancreatitis.
Blood test: WBC rising 12k, amylasemia normal.
Operation laparotomy detected all bowel in dilatation but no necrosis, no tumor obstruction.
Many white spots like candle intra peritoneum.
Retroperitoneal space edema. Surgeon said chronic pancreatitis.
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Operation laparotomy detected all bowel in dilatation but no necrosis, no tumor obstruction.
Many white spots like candle intra peritoneum.
Retroperitoneal space edema. Surgeon said chronic pancreatitis.
Discussion of this case: clinical findings were abdominal pain and distension for one week. XRay and ultrasound found out bowel obstruction and CT detected pancreatitis, but blood test amylasemia was 17 unit.
Surgeon decided operation by bowel obstruction.
Now report is chronic pancreatitis, it is a rare case with normal amylasemia in acute pancreatitis.
Now report is chronic pancreatitis, it is a rare case with normal amylasemia in acute pancreatitis.
REFERENCE: case report
