Necrotising pancreatitis

Case contributed by Dr Bruno Di Muzio

Presentation

Day three after onset presentation and admission due to upper abdominal pain. Elevation of amylase and lipase.

Patient Data

Age: 44-year-old

CT Abdomen

Modality: CT

Acute necrotic collection (ANC) in the pancreatic tail with surrounding retroperitoneal inflammatory changes, predominantly characterised by diffuse phlegmon and necrotic collections. Fluid in the anterior pararenal spaces tracks down until the pelvis. There is no lymph node enlargement. The liver, spleen, kidneys and adrenal glands are normal. Reactive enhancement of the common bile duct. Diffuse reactive duodenal thickening as well as mild colonic wall thickening.

There is mild dilatation of the proximal jejunum, likely reactive. No free gas. No suspicious bone lesions are seen. Bilateral small pleural effusion and associated restrictive atelectasis. Small pericardial effusion.

Case Discussion

The non-enhancing low attenuating regions within the pancreatic tail, involving more than 30% of its parenchyma, compatible with acute necrotic collections (ANCs). Features are those of severe pancreatitis accordingly to the CT severity index. 

PlayAdd to Share

Case Information

rID: 46731
Case created: 14th Jul 2016
Last edited: 11th Sep 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.