The pancreas transplant is difficult to monitor both clinically and by imaging. Complications such as thrombosis, infection, pancreatitis, bleeding, anastomotic leak, or rejection may quickly progress to transplant failure. Ultrasound, CT, MR imaging, fluoroscopy, nuclear scintigraphy, and angiography may be used to help define the etiology of transplant compromise; however, all have marked limitations, and none has proved to be the study of choice. The surgeon and radiologist must carefully coordinate clinical suspicion with the strengths of the various modalities to optimize a timely diagnosis.
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