Acute pancreatitis with infected necrosis

Case contributed by Bruno Di Muzio


Patient hospitalized for five days with a diagnosis of pancreatitis.

Patient Data

Age: 70 years
Gender: Female

CT Abdomen and pelvis


Extensive pancreatic inflammation associated with multiple small adjacent collections, one of these, the bigger one, permeates the pancreatic parenchyma in the body and tail (pancreatic necrosis), with gas bubbles within.

Note: Failure technique allowed the small injection of contrast medium prior to acquisitions, so renal excretion is seen.

Case Discussion

One of the most feared complications of acute pancreatitis is infected pancreatic necrosis.

The only sign on CT that allows the diagnosis of infected pancreatic necrosis is the identification of gas bubbles through the parenchymal necrosis, since the patient has not undergone any intervention or operated upon. This condition is also known as emphysematous pancreatitis.

Some authors advocate the differentiation between infected pancreatic necrosis and pancreatic abscess, reserving the use of the term pancreatic abscess for the condition in which identifies a more well-defined accumulation of liquid, while the infected pancreatic necrosis would be more diffuse, ill-defined and with anarchic distribution of gas inside.

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