Necrotizing pancreatitis with walled-off collections

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

History of acute pancreatitis 5 weeks ago. Now abdominal pain and swelling.

Patient Data

Age: 50 years
Gender: Female

The pancreatic tail shows a small necrotic collection with hypointense shaggy irregular wall. Associated with extensive peripancreatic multilocular walled-off necrotic collections showing irregular and enhancing margins. Smudging of the surrounding fat planes. Attenuated splenic vein with an occluded distal segment. Large gallbladder stone showing mural thickening.

Case Discussion

Necrotizing pancreatitis is complicated early by acute necrotic collections (ANC) and later by walled-off necrotic collections (WON).

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