It happens that the patient with complaints of right-sided pain is sent for echosonography, and after the procedure, a record appears in the conclusion about the heterogeneity of the pancreas structure. Under this mysterious conclusion, there is usually a suspicion of pancreatitis.
This is characteristic of acute pancreatitis at the very beginning of its development and chronic pancreatitis in the early years. Then the heterogeneous structure of the diseased organ can become more homogeneous, since the disease affects the most part of the gland, while the changes are still noticeable if you compare the iron with the liver.
In this case, depending on the nature of the heterogeneity and its vastness, an experienced specialist can determine which of the five main options for the development of chronic pancreatitis is more likely for this patient.
- Subacute variant: in its symptoms it is like acute pancreatitis, but it lasts much longer. On the ultrasound of the pancreas the heterogeneity of the organ structure is observed, caused by the chaotic alternation of areas of high and low density in combination with increased in volume gland and fuzziness of the contours. At the remission stage, the sizes are normalized, and its contours become clearer.
- The parenchymal variant is characterized by fuzzy, hardly noticeable changes towards heterogeneity during periods of exacerbation, and during the remission period the pancreas of the patient may hardly differ from that of a healthy person.
- Fibrous-sclerotic variant of the characteristic pattern of ultrasonography will be areas of increased density in combination with calcitans, eventually transforming into diffuse.
- The cystic variant differs from the rest by a change in the homogeneous structure of the gland, which manifests itself in the form of a large number of cysts, which are easily detected by ultrasound examination simultaneously with uneven contours of the organ and a small number of dense, fluid-filled structures.
- The hyperplastic variant on ultrasound is manifested in the form of an enlarged part of the pancreas. At the same time, the structure is so heterogeneous that it is often called motley. Heterogeneity shows itself in the form of zones of increased density, in which there are small inclusions of pseudocysts with foci of reduced density.