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Extensive regions of the pancreatic head and body show poor enhancement and are replaced by a large fluid density collection, consistent with necrosis. The pancreas is enlarged and oedematous, with surrounding fat stranding and fluid tracking in the anterior pararenal spaces bilaterally and also extending into the pelvis.
These features are in keeping with severe necrotising pancreatitis. There are peritoneal free fluid and bilateral pleural effusions. No radiopaque gallstones or biliary dilatation.