Presentation
Abdominal pain and vomiting since a month ago with recent abdominal progressive distention.
Patient Data
The pancreas is enlarged and shows homogeneous enhancement without evidence of parenchymal necrosis. Multiple-varying sized heterogeneous fluid collections with enhancing walls are seen in abdominal spaces, more around the pancreas, and causing mass effect suggesting walled-off necrosis (WON).
Case Discussion
Walled-off necrosis (WON) is a potential sequelae of pancreatitis.
On imaging, they are fluid collections with a relatively thick and enhancing wall, usually located in the pancreatic bed. They can be differentiated from pseudocysts because WON contents are more heterogeneous and often show necrotic pancreas or necrotic fat (as in this example). If it is unclear whether a peripancreatic fluid collection is a pseudocyst or walled-off necrosis, MRI can be useful to help differentiate.