The patient was referred for an ultrasound examination of the kidneys because the referring physician only wanted to rule out stones in the urinary tract.  The fluid around the spleen however suggested other pathology. One of the causes of fluid in this area is a pancreatitis because the tail of the pancreas is in close relation to the spleen.

In an early stage of a pancreatitis the ultrasound findings can be very subtle. Ultrasound findings in pancreatitis include edema with swelling of the pancreas. Changes in echogenicty can be focal or diffuse. Peripancreatic changes include edema and fluid collections.

A CT scan is often the method of choice to examine the entire pancreatic and peripancreatic changes in patients with pancreatitis. There are however patients such as this patient where ultrasound can demonstrate these changes in pancreatitis. Also ultrasound is the method of choice to demonstrate the presence of gallstones in the biliary tract that can be a cause of a biliary pancreatitis. Especially small stones in a non dilatated common bile duct can be hard to detect. A careful examination of the papil area is necessary to avoid missing these stones.

Laboratory findings like Amylase and Lipase later confirmed the diagnosis pancreatitis