Pacsbin
Case 6: 45 year-old male with epigastric pain and elevated lipase.
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Key findings:
Striking hypoenhancement of the pancreatic head and body.
Some sparing of the
uncinate process
,
distal body,
and
tail.
Acute necrotic collections (stranding/fluid density) surrounding the pancreas
Noncclusive thrombus in the splenic vein
Nonocclusive thrombus in the superior mesenteric vein
RML segmental pulmonary embolus.
Small pleural effusions with atelectasis
Ascites
.
Anasarca
.
Coronary artery atherosclerosis
2-months later:
Key findings:
Necrotic pancreatic head and body now replaced by walled-off necrosis (WON)
Mass effect and reactive inflammation involving the stomach and duodenum, with mucosal hyperenhancement and submucosal edema.
Mass effect from WON is obstructing the common bile duct.
A small amount of pancreatic parenchyma near the tail has a dilated duct, which is presumably communicating with the walled-off necrosis.