Acute necrotic collection

Last revised by Ryan Thibodeau on 27 Jul 2024

Acute necrotic collections (ANCs) are an early, local complication of necrotizing pancreatitis.

The following are the latest terms according to the updated Atlanta classification to describe fluid collections associated with acute pancreatitis 1,2:

Acute necrotic collections develop within the first four weeks and contain a variable amount of fluid/non-liquid necrotic material. They may be pancreatic or peripancreatic in location and can be sterile or infected. 

On contrast-enhanced CT the following features are seen:

  • heterogeneous, non-liquid density collection within the pancreas and/or peripancreatic tissues

    • fat in the collection allows the diagnosis of an ANC even on nonenhanced CT 4

  • no defined capsule

  • no peripheral enhancement

Cases and figures

  • Case 1
  • Case 2

Imaging differential diagnosis

  • Case 1: acute peripancreatic fluid collection in interstitial pancreatitis
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