Day three after onset presentation and admission due to upper abdominal pain. Elevation of amylase and lipase.
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Acute necrotic collection (ANC) in the pancreatic tail with surrounding retroperitoneal inflammatory changes, predominantly characterized 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.