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Necrotizing pancreatitis - acute necrotic collection maturing into walled-off pancreatic necrosis

Case contributed by Andrew Dixon
Diagnosis certain

Presentation

Abdominal pain.

Patient Data

Age: 35 years
Gender: Male

Acute pancreatitis is with pancreatic edema with large non enhancing parenchymal areas (necrotic), peripancreatic fluid (ANC) and fluid tracking within the anterior pararenal space.

Pancreatic parenchyma is replaced by large pancreatic and peripanreatic encapsulated collections with areas of hemorrhage. 

Case Discussion

This collection makes the criteria for an acute necrotic collection and walled-off pancreatic necrosis as a complication of "necrotizing pancreatitis". It is not to be confused with pseudocyst, which occurs later than 4 weeks following interstitial edematous pancreatitis and is more uniformly round with enhancing margins.

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