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[20th anniversary of sonographic diagnosis of the pancreas].

During the past 20 years sonographic diagnosis of pancreatic diseases has developed from isolated case reports into a differentiated method. It is particularly suited for prognostic reviewing of acute pancreatitis and for detection of typical complications in acute pancreatitis and pancreatic trauma. Its contribution to the detection of chronic pancreatitis in on-target examination is also highly significant. Carcinomas of the pancreas can be detected with a good degree of sensitivity if their diameter is equal to or exceeds 1.5 cm. Other problems deserving attention are those of differential diagnosis of low-echo space-occupying growths at the pancreas and the differentiation against circumscribed chronic pancreatitis. Sonographically aimed fine needle puncture is a suitable complementary examination. Doubts must be voiced against the value of sonographic diagnosis of the pancreas within the overall framework of so-called mass screenings.