Clinical Presentation

Severe epigastric pain in a child on chemotherapy for acute lymphocytic leukemia.

An axial post-contrast computed tomography (CT) image of the upper abdomen demonstrates a swollen, heterogeneous, edematous-appearing pancreas (arrow) with surrounding fluid and inflammatory changes and a small amount of ascites. Neither the pancreatic nor the biliary ducts are dilated.

Differential Diagnosis

• Acute pancreatitis: The inflammatory changes in the pan-creas are diagnostic of pancreatitis, and the lack of ductal dilatation argues against an obstructive etiology.

• Traumatic pancreatitis: