Duodenal filling grade determined at MR pancreatography after secretin stimulation allows specific estimation of pancreatic exocrine function.

Magnetic resonance (MR) imaging of the pancreas has undergone a major change because of its capability of providing noninvasive images of the pancreatic ducts, cross-sectional images of the parenchyma analogous to computed tomography (CT) images, and angiographic depiction of blood vessels. Recent technical issues include the use of half-Fourier T2-weighted pulse sequences and the administration of secretin for MR cholangiopancreatography (MRCP). Secretin improves pancreatic duct and side-branch delineation and the detection of anatomic variants such as pancreas divisum. It allows monitoring of pancreatic flow dynamics and evaluation of pancreatic exocrine function. Although contrast material--enhanced CT is still considered the standard of reference in severe acute pancreatitis and for the detection of calcifications in chronic pancreatitis, in patients referred for suspicion of pancreatic disease or with recurrent acute pancreatitis, MR imaging and secretin-enhanced MRCP are useful after unenhanced CT suggests the cause of disease. In advanced inflammatory disease, MR imaging and secretin-enhanced MRCP are useful for planning surgery or therapeutic endoscopy and for follow-up studies after therapy. MR imaging in combination with secretin-enhanced MRCP and MR angiography is useful in identifying pancreatic malignancies and in establishing resectability.

A severe multisystem inflammatory syndrome associated with Kawasaki disease manifestations (MIS-C) has been recently reported in children with signs of recent infection with SARS-CoV-2. We here reported the case of a young adult woman who presented the complete manifestations of Kawasaki disease associated with a severe myocarditis, acute respiratory distress syndrome and hemodynamic instability a few weeks after a transient anosmia. The detection of specific antibodies to SARS-CoV-2 in the absence of detection of the virus suggested that the syndrome was the result of a delayed immune response to a recent COVID-19 infection. A combined treatment with colchicine, tocilizumab, high dose immunoglobulins, and methylprednisolone allowed to control the inflammatory process and to limit the development of coronary aneurysm. The patient recovered without sequelae. This case emphasized the importance of SARS-CoV-2 serology for the diagnosis of delayed immune complications of COVID-19. Clinicians caring for adult patients must be aware that not only children but also young adults can be affected by a multisystem inflammatory syndrome with KD features associated with COVID-19.

No abstract

MDCTA using iodixanol is a promising, noninvasive alternative for evaluating patients with abdominal aortic disease.