There is a very important organ deep in the upper abdomen of our body, which lies in front of the 1st-2nd lumbar vertebrae, adjacent to the stomach in front, the C-shaped loop of the duodenum on the right, and the spleen on the left. It is a gland with both exocrine and endocrine functions, secreting pancreatic juice into the duodenum to promote the digestion and absorption of nutrients, and secreting insulin to play a key role in regulating blood sugar levels. This organ is the pancreas. The general anatomy of the pancreas is worrisome because epidemiological studies show that the incidence of pancreatic disease is increasing every year. Studies have shown that obesity, high-fat diet and smoking are high risk factors for pancreatic cancer. The pancreatic gland is so important, yet it is often overlooked. People often think that pain in the upper abdomen is the proverbial “upset stomach”, which is a misunderstanding due to the special anatomical location of the pancreas. The pancreas is located at the back of the stomach and has an insidious onset with no specific clinical manifestations, making early diagnosis difficult. Pancreatic diseases include: pancreatitis (acute, chronic) and pancreatic tumors. Pancreatic tumors are subdivided into benign, junctional (malignant potential), and malignant tumors. The head of the pancreas is the most common site for pancreatic tumors, accounting for about 70% of cases, followed by the body of the pancreas and the tail of the pancreas. Pancreatic nodules can be cystic, mixed cystic and solid on ultrasound. Ultrasonography of the pancreas Ultrasonography is the preferred method for the screening and diagnosis of pancreatic tumors. However, due to the special anatomical location of the pancreas (deep location and small volume), relatively high influence by gastrointestinal gas, and numerous surrounding adjacent organs, pancreatic nodules smaller than 1 cm
The detection rate of pancreatic nodules smaller than 1 cm by conventional ultrasound is low, and the qualitative diagnosis of pancreatic limited inflammatory masses is often difficult. Therefore, before pancreatic ultrasound examination, it is necessary to be well prepared: fasting and water fasting for more than 8 hours, evacuation of stool and barium in the body, and no gastroscopy on the same day. It is best to bring other referable clinical information and plain water (500-700 ml) for backup. In case of suspicious lesions, it is very important to have a consultation with a senior specialist, and further ultrasonography may be done as needed. Ultrasonography has been widely used as a new ultrasound technique in the clinic in recent years. Ultrasonography is performed by intravenous injection of contrast agent. These contrast agents are tiny bubbles that evaporate rapidly through the lung tissue, so they do not cause harm to the human body. This technique has an important role in the differential diagnosis of benign and malignant pancreatic masses, and it can reflect the adjacent relationship of the blood vessels around the masses well, which helps in the preoperative evaluation.