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Necrotizing pancreatitis with walled-off necrotic collection

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Diabetic patient had a history of acute epigastric pain and elevated amylase levels about 5 weeks ago.

Patient Data

Age: 50 years
Gender: Male

Swollen pancreas with non enhancing parenchyma (sparing the pancreatic tail) in keeping with "necrotizing pancreatitis", the pancreas is surrounded by large capsulated peripancreatic fluid collection which is abutting the stomach anteriorly. Smudging and fluid edema are seen at the peripancreatic fat planes.

Loss of signal void & post contrast enhancement of the splenic vein (likely thrombosed)

Case Discussion

Features of necrotizing pancreatitis with surrounding organizing collection "walled-off pancreatic collection" and stranding, along with thrombosed splenic vein. 

The following are the latest terms according to the updated Atlanta classification to describe fluid collections associated with acute pancreatitis:

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