The appearances are of chronic pancreatitis.

Worldwide, alcohol excess is the commonest cause although there is a wide differential.

Starting with the CXR this makes a decent examination viva case:

• spot the film edge (review area) of the chest radiograph abnormality of upper abdominal calcification
• this earns the abdominal radiograph to permit confirmation
• CT follows to facilitate a discussion on the causes of pancreatic calcification and the causes of chronic pancreatitis