Complete pancreatic lipomatosis
Diabetic patient with chronic abdominal pain
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The pancreas is visualized showing nearly complete replacement by diffuse fatty density. There is evidence of a relatively large nearly rounded inhomogeneous density noted within the retroperitoneal region within the pancreatic head site and abutting the superior mesenteric vein as well as minimally the confluence of the portal vein. It measures ~34 x 31 mm (AP x ML) with irregular margins and mild stranding of the surrounding fat as well as faint mild enhancing wall and internal turbid contents/septa with a small enhancing center.
Images are suggestive of loculated fluid most likely due to focal acute pancreatitis of the head of the pancreas.