Necrotizing pancreatitis with acute necrotic collections
Four days of LUQ/episgastric pain. Nauseated.
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The pancreatic body and tail is edematous with surrounding fat stranding. An post contrast imaging there are areas of non-enhancing pancreas within the body in keeping with small areas of necrosis. In the left upper quadrant there I extensive multiloculated collections which appear well retroperitoneal. One of the collections extends into the left diaphragmatic crus.
Prominent portal and splenic veins have developed since the prior CT. Para-esophageal soft tissue density – lymph node vs. varices. Liver, spleen, adrenal glands, kidneys and gallbladder are unremarkable. Bowel is unremarkable. Reactive thickening of the posterior stomach wall. Trace pelvic free fluid. Lung bases are clear. No suspicious bony lesion.