Walled-off pancreatic necrosis

Case contributed by Dr Mostafa El-Feky

Presentation

Epigastric pain.

Patient Data

Age: 60 years
Gender: Male
CT

CT abdomen with contrast

The pancreas shows multiple ductal and parenchymal calcifications, as well as hypodensity of the tail, associated with multiple collections, mostly non-encapsulated, mainly in the lesser sac and porta hepatis, insinuating into the subcapsular and periportal spaces, in keeping with acute on chronic pancreatitis, with acute peripancreatic fluid collections.  

Portal thrombophlebitis involving the right posterior branch of the portal vein, associated with a small hepatic abscess in segments VII and VIII.

Mild ascites and bilateral minimal pleural effusions.

Generalized edema.

Case Discussion

Walled-off pancreatic necrosis occurs as a late complication of acute pancreatitis and can occur in chronic pancreatitis. It is not to be confused with pseudocyst, which occurs later than 4 weeks following pancreatitis and is more uniformly round with enhancing margins.

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Case information

rID: 53729
Published: 28th Jun 2017
Last edited: 5th May 2019
Inclusion in quiz mode: Included

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